Individual provider Active NPI

Hershel R Patel, MD

  • Retina Specialist (Ophthalmology) Physician
  • Winter Haven, FL
National Provider Identifier
1801216072
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
ME145015 Issued in FL
Practice address
250 Avenue K SW Ste 200
Winter Haven, FL 33880-3919
Phone
(863) 297-5400
Fax
(833) 989-0315
NPI assigned
Apr 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME145015 FL
Retina Specialist (Ophthalmology) Physician 207WX0107X ME145015 FL Primary

Addresses

Primary practice location

250 Avenue K SW Ste 200
Winter Haven, FL 33880-3919

Mailing address

250 Avenue K SW Ste 200
Winter Haven, FL 33880-3919
Phone (863) 297-5400

Other practice location 1

2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224
Phone (863) 297-5400

Other practice location 2

6719 Gall Blvd Ste 206
Zephyrhills, FL 33542-2569
Phone (863) 297-5400

Other practice location 3

4636 Bellwether Lane
Oxford, FL 34484
Phone (863) 297-5400

Other identifiers 1

IdentifierTypeStateIssuer
106409100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hershelpatel@direct-address.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200601001209 FL Practitioner - Ophthalmology 0143578872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitreous and Retina Consultants PAGroup PAC ID 0648172882, 5 clinicians

Practice addresses (Care Compare)

250 Ave K SW
Suite 200
Winter Haven, FL 33880-3919
Phone (863) 297-5400

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145015FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitreous and Retina Consultants, LLC Ophthalmology CurrentSince Jul 1, 2020 Accepting new patients
Vitreous & Retina Consultants, PA Ophthalmology CurrentSince Jul 1, 2020 Accepting new patients

Locations

1655 E Highway 50
Ste 202
Clermont, FL 34711
Phone (352) 242-0204

137 Patterson Rd
Haines City, FL 33844
Phone (407) 254-0005

2815 Lakeland Hills Blvd
Ste 200
Lakeland, FL 33805
Phone (863) 297-5400

4636 Bellwether Ln
Oxford, FL 34484
Phone (863) 297-5400

5233 US 27 N
Ste 1
Sebring, FL 33870

250 Avenue K SW
Ste 200
Winter Haven, FL 33880
Phone (863) 297-5400

6719 Gall Blvd
Ste 206
Zephyrhills, FL 33542
Phone (813) 708-6990

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: hpatel@crmd.emadirect.md

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1801216072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 AVENUE K SW STE 200",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803919",
            "telephone_number": "863-297-5400",
            "fax_number": "833-989-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 AVENUE K SW STE 200",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803919",
            "telephone_number": "863-297-5400",
            "fax_number": "833-989-0315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2815 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338052224",
            "country_code": "US",
            "telephone_number": "863-297-5400",
            "fax_number": "833-989-0315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6719 Gall Blvd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335422569",
            "country_code": "US",
            "telephone_number": "863-297-5400",
            "fax_number": "833-989-0315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4636 Bellwether Lane",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "FL",
            "postal_code": "34484",
            "country_code": "US",
            "telephone_number": "863-297-5400",
            "fax_number": "833-989-0315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HERSHEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-25",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME145015",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME145015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106409100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hershelpatel@direct-address.net",
            "affiliation": "N",
            "endpointDescription": "hershelpatel@direct-address.net",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4636 Bellwether Lane",
            "city": "Oxford",
            "state": "FL",
            "country_code": "US",
            "postal_code": "34484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.