Individual provider Active NPI

Amita N Patel, M.D.,

  • Pediatric Adolescent Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1053466672
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
25MA03959800 Issued in NJ
Practice address
817 Rahway Ave
Elizabeth, NJ 07202-2212
Phone
(908) 353-5750
Fax
(908) 355-2452
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 25MA03959800 NJ Primary

Addresses

Primary practice location

817 Rahway Ave
Elizabeth, NJ 07202-2212

Mailing address

817 Rahway Ave
Elizabeth, NJ 07202-2212
Phone (908) 353-5750

Other identifiers 1

IdentifierTypeStateIssuer
0433705MedicaidNJ

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03959800NJMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Pediatrics Group Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23997/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053466672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 RAHWAY AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022212",
            "telephone_number": "908-353-5750",
            "fax_number": "908-355-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 RAHWAY AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022212",
            "telephone_number": "908-353-5750",
            "fax_number": "908-355-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMITA",
        "middle_name": "N",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA03959800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0433705",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.