Individual provider Active NPI

Nileshkumar G. Patel, MD

  • Family Medicine Physician
  • Patchogue, NY
National Provider Identifier
1043316755
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
189692-1 Issued in NY
Practice address
1 E Roe Blvd
Patchogue Medical Group,LLP
Patchogue, NY 11772-2631
Phone
(631) 475-3900
Fax
(631) 475-5166
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 189692-1 NY Primary

Addresses

Primary practice location

1 E Roe Blvd
Patchogue Medical Group,LLP
Patchogue, NY 11772-2631

Mailing address

1 E Roe Blvd
Patchogue Medical Group,LLP
Patchogue, NY 11772-2631
Phone (631) 475-3900

Other identifiers 1

IdentifierTypeStateIssuer
01341120MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051031000107 NY Practitioner - Family PracticePractitioner - Internal Medicine 8325065295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Caremed Primary and Urgent Care PCGroup PAC ID 8224353727, 21 clinicians

Practice addresses (Care Compare)

1 E Roe Blvd
Patchogue, NY 11772-2631
Phone (631) 475-3900

Hospital & facility affiliations

  • Tender Loving Care, an Amedisys Company Home health agency, Medford, NY, CCN 337260
  • Extended Home Care Home health agency, Brooklyn, NY, CCN 337414
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
189692-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caremed Primary and Urgent Care PC Family Medicine CurrentSince Jan 1, 2019 Accepting new patients

Locations

266 Middle Country Rd
Coram, NY 11727
Phone (631) 475-3900

1 E Roe Blvd
Patchogue, NY 11772
Phone (631) 475-3900

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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.

Hospital & facility affiliations 5

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1043316755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E ROE BLVD",
            "address_2": "PATCHOGUE MEDICAL GROUP,LLP",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722631",
            "telephone_number": "631-475-3900",
            "fax_number": "631-475-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ROE BLVD",
            "address_2": "PATCHOGUE MEDICAL GROUP,LLP",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722631",
            "telephone_number": "631-475-3900",
            "fax_number": "631-475-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NILESHKUMAR",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "189692-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01341120",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.