Individual provider Active NPI

Laxeshkumar Bubulal Patel, M.D.

  • Psychiatry Physician
  • Kokomo, IN
National Provider Identifier
1790096782
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01075281A Issued in IN
Practice address
322 N Main St
Kokomo, IN 46901-4622
Phone
(765) 453-8555
NPI assigned
Jun 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01075281A IN Primary

Addresses

Primary practice location

322 N Main St
Kokomo, IN 46901-4622

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805

Other identifiers 1

IdentifierTypeStateIssuer
201300440MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lpatel169903@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717001155 IN Practitioner - Psychiatry 6800109950 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3500 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 453-8547

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc Current Accepting new patients
Community Howard Regional Health Inc CurrentSince Jun 9, 2015 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 8, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 8, 2017 Accepting new patients
Community Health Network, Inc CurrentSince Sep 24, 2024 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

205 N Jackson St
Frankfort, IN 46041
Phone (765) 659-4771

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7165 Clearvista Way
Indianapolis, IN 46256
Phone (317) 621-5100

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

322 N Main St
Kokomo, IN 46901
Phone (765) 453-8238

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

Interoperability endpoints

  • Direct secure messaging: lpatel169903@ecommunitydirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1790096782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N MAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014622",
            "telephone_number": "765-453-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "LAXESHKUMAR",
        "middle_name": "BUBULAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01075281A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201300440",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpatel169903@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "322 N Main St",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469014622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.