Individual provider Active NPI

Indravadan Ishwarbhai Patel

  • Internal Medicine Physician
  • Bridgewater, NJ
National Provider Identifier
1013627496
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD034243L Issued in PA
Practice address
66 Shaffer Rd
Bridgewater, NJ 08807-5606
Phone
(908) 392-6635
NPI assigned
Nov 28, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD034243L PA Primary

Addresses

Primary practice location

66 Shaffer Rd
Bridgewater, NJ 08807-5606

Mailing address

66 Shaffer Rd
Bridgewater, NJ 08807-5606
Phone (908) 392-6635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MD034243LPAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1013627496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 SHAFFER RD",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075606",
            "telephone_number": "908-392-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SHAFFER RD",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075606",
            "telephone_number": "908-392-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "INDRAVADAN",
        "middle_name": "ISHWARBHAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD034243L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.