Individual provider Active NPI

Mayuri H Patel, MD

  • Interventional Cardiology Physician
  • Lakeland, FL
National Provider Identifier
1821265422
Registry record updated Sep 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME141240 Issued in FL
Practice address
130 Pablo St
Lakeland, FL 33803-3818
Phone
(863) 284-5020
Fax
(863) 284-5912
NPI assigned
May 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MA07412400 NJ
Interventional Cardiology Physician 207RI0011X MD456332 PA
Interventional Cardiology Physician 207RI0011X ME141240 FL Primary

Addresses

Primary practice location

130 Pablo St
Lakeland, FL 33803-3818

Mailing address

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpatel49516@LRHS.direct-ci.com 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
I20210416000755 FL Practitioner - Cardiovascular Disease (Cardiology) 9638241433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

130 Pablo St
Lakeland, FL 33803-3818
Phone (863) 284-5941

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting48
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA07412400NJMDCardiovascular Disease Physician
ME141240FLMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 30, 2019 Accepting new patients
St Luke's Physician Group Inc CurrentSince Jul 29, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Lakeland Regional Health Systems, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Jul 30, 2019 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jul 29, 2019 Accepting new patients
Mainland Heart Consultants Cardiovascular Disease Past Accepting new patients
Physicians Unity PastSince Aug 30, 2020 Accepting new patients
Acadian Physician Practices LLC Past Accepting new patients

Locations

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

130 Pablo St
Lakeland, FL 33803
Phone (863) 284-5064

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

446 N Reading Rd
Ste 302
Ephrata, PA 17522
Phone (717) 721-5868

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mpatel49516@lrhs.direct-ci.com

Organizations & group practices 10

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663459200000",
    "number": "1821265422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1100",
            "fax_number": "863-630-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PABLO ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033818",
            "telephone_number": "863-284-5020",
            "fax_number": "863-284-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAYURI",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2022-09-18",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA07412400",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD456332",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME141240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpatel49516@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "130 Pablo St",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338033818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.