Individual provider Active NPI

Pradip D Patel, MD

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1003891599
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29724 Issued in KY
Practice address
9702 Stonestreet Rd
Ste 100
Louisville, KY 40272-6809
Phone
(502) 588-0610
Fax
(502) 588-0611
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29724 KY Primary

Addresses

Primary practice location

9702 Stonestreet Rd
Ste 100
Louisville, KY 40272-6809

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0610

Other identifiers 2

IdentifierTypeStateIssuer
200080580MedicaidIN
64297245MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100108000752 KY Practitioner - Pediatric Medicine 4082755301 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29724KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Pediatrics CurrentSince Sep 1, 2012 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

9702 Stonestreet Rd
Ste 100
Louisville, KY 40272
Phone (502) 588-0610

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1003891599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0610",
            "fax_number": "502-588-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9702 STONESTREET RD",
            "address_2": "STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402726809",
            "telephone_number": "502-588-0610",
            "fax_number": "502-588-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRADIP",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "29724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200080580",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64297245",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.