Individual provider Active NPI

Mitkumar Patel, M.D.

  • Cardiovascular Disease Physician
  • Fayetteville, GA
National Provider Identifier
1912293812
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
83337 Issued in GA
Practice address
1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110
Phone
(770) 716-0051
NPI assigned
Jun 20, 2011
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 83337 GA Primary

Addresses

Primary practice location

1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110

Mailing address

2727 Paces Ferry Rd SE Ste 1-1100
Atlanta, GA 30339-6151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190909004263 GA Practitioner - Cardiovascular Disease (Cardiology) 1153542303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W
Suite 2200
Fayetteville, GA 30214
Phone (770) 716-0051

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Aug 19, 2019 Accepting new patients
Piedmont Professional Services, LLC Cardiovascular Disease Past Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1912293812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 PACES FERRY RD SE STE 1-1100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142110",
            "telephone_number": "770-716-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MITKUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "83337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.