Pediatric Specialty Physicians, PC

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

Legal business name

PEDIATRIC SPECIALTY PHYSICIANS, PC

Practice address

7429 Inverness Commons
Fort Wayne, IN 46804-3837

Phone

(260) 408-5801

Fax

(888) 949-8258

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jayesh P Patel, M.D.

Title

President

Phone

(260) 408-5801

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JAYESH P. PATEL, MD Doing business as

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1023198926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7429 INVERNESS COMMONS",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043837",
            "telephone_number": "260-408-5801",
            "fax_number": "888-949-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7429 INVERNESS COMMONS",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468043837",
            "telephone_number": "260-408-5801",
            "fax_number": "888-949-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPECIALTY PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JAYESH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-408-5801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200301280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAYESH P. PATEL, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Critical Care Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pediatric Critical Care Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.