Individual provider Active NPI

Nathan Tushar Patel, MD

  • Internal Medicine Physician
  • Tannersville, PA
National Provider Identifier
1033420419
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD477991 Issued in PA
Practice address
2838 Route 611
Tannersville, PA 18372-7923
Phone
(570) 476-3336
Fax
(570) 839-7210
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16488 NH
Internal Medicine Physician 207R00000X MD477991 PA Primary
Family Medicine Physician 207Q00000X 4301097238 MI

Addresses

Primary practice location

2838 Route 611
Tannersville, PA 18372-7923

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (570) 501-6368

Other practice location 1

555 Linn St
Allegan, MI 49010-1524
Phone (269) 686-4110

Other practice location 2

6838 Elm Valley Dr
Kalamazoo, MI 49009
Phone (269) 552-4233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Oct 27, 2017 Accepting new patients

Locations

551 Linn St
Allegan, MI 49010
Phone (269) 686-5800

6938 Elm Valley Dr
Ste 101
Kalamazoo, MI 49009
Phone (269) 552-4167

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

6938 Elm Valley Dr
Kalamazoo, MI 49009
Phone (269) 341-7272

Organizations & group practices 1

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1033420419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "570-501-6368",
            "fax_number": "570-501-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2838 ROUTE 611",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183727923",
            "telephone_number": "570-476-3336",
            "fax_number": "570-839-7210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Linn St",
            "address_purpose": "LOCATION",
            "city": "Allegan",
            "state": "MI",
            "postal_code": "490101524",
            "country_code": "US",
            "telephone_number": "269-686-4110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6838 Elm Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "49009",
            "country_code": "US",
            "telephone_number": "269-552-4233",
            "fax_number": "269-552-4216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NATHAN",
        "middle_name": "TUSHAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NH",
            "license": "16488",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD477991",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301097238",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tannersville, PA

Sources for this page

Verify at the official NPI Registry.