Individual provider Active NPI

Monali Hanmant Patil, M.D

  • Critical Care Medicine (Internal Medicine) Physician
  • Fort Smith, AR
National Provider Identifier
1952620544
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
E-11813 Issued in AR
Practice address
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone
(479) 314-6030
NPI assigned
May 23, 2010
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X E-11813 AR Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 99756 GA
Pulmonary Disease Physician 207RP1001X ME126843 FL
Pulmonary Disease Physician 207RP1001X E-11813 AR

Addresses

Primary practice location

7301 Rogers Ave
Fort Smith, AR 72903-4100

Mailing address

1875 NW Corporate Blvd Ste 270
Boca Raton, FL 33431-8550
Phone (561) 997-0821

Other practice location 1

1875 NW Corporate Blvd Ste 270
Boca Raton, FL 33431
Phone (561) 997-0821

Other practice location 2

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Other identifiers 1

IdentifierTypeStateIssuer
709623MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190624002009 AR Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 5395018360 Reassigns benefits to 1 organization
I20240718002184 GA Practitioner - Pulmonary Disease 5395018360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99756GAMDCritical Care Medicine (Internal Medicine) Physician
E-11813ARMDPulmonary Disease Physician
ME126843FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Sep 1, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Aug 1, 2019 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Aug 1, 2019 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Sep 1, 2024 Accepting new patients
Icc Healthcare LLC Critical Care Medicine Past Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

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

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": "1274572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1952620544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 NW CORPORATE BLVD STE 270",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334318550",
            "telephone_number": "561-997-0821",
            "fax_number": "561-997-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034100",
            "telephone_number": "479-314-6030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 NW Corporate Blvd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "33431",
            "country_code": "US",
            "telephone_number": "561-997-0821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Northside Forsyth Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417659",
            "country_code": "US",
            "telephone_number": "770-844-3200",
            "fax_number": "770-292-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATIL",
        "first_name": "MONALI",
        "middle_name": "HANMANT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-23",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AR",
            "license": "E-11813",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "99756",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME126843",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E-11813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "709623",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.