Bharatkuma C Patel, MD
Individual provider Active NPI Specialist · Deland, FL
NPI 1922057249 · NPPES record last updated Jan 15, 2015
Key facts
- NPI
- 1922057249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- ME47637 (FL)
- Practice address
- 1070 N Stone St
Suite D
Deland, FL 32720-0919 - Phone
- (386) 822-9410
- Fax
- (386) 469-0045
- NPI assigned
- May 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080728000196 | FL | Practitioner - Gastroenterology | 0547359853 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital-West Volusia Inc | Current |
Accepting new patients | |
| Memorial Hospital-West Volusia Inc | Current |
Accepting new patients | |
| Southwest Volusia Healthcare Corporation | Past | Accepting new patients |
Locations
701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160
1070 N Stone St
Ste D
Deland, FL 32720
Phone (386) 822-9410
301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906
1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- bpatel73642@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME47637 | FL | Yes |
Addresses
Primary practice location
1070 N Stone St
Suite D
Deland, FL 32720-0919
Mailing address
1070 N Stone St
Suite D
Deland, FL 32720-0919
Phone (386) 822-9410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 593256803 | Other | FEI # | |
| 044545200 | Medicaid | FL |
Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.