Individual provider Active NPI

Kishor K. Patel, M.D.

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1053489500
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
062185 Issued in MI
Practice address
VA Ann Arbor Healthcare System
2215 Fuller Road
Ann Arbor, MI 48105
Phone
(734) 845-5290
Fax
(734) 845-5288
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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 062185 MI Primary

Addresses

Primary practice location

VA Ann Arbor Healthcare System
2215 Fuller Road
Ann Arbor, MI 48105

Mailing address

VA Ann Arbor Healthcare System
2215 Fuller Road
Ann Arbor, MI 48105
Phone (734) 845-5290

Other practice location 1

Henry Ford Health System
2755 Carpenter Road
Ann Arbor, MI 48108
Phone (734) 973-3090

Other identifiers 4

IdentifierTypeStateIssuer
700H262220OtherBLUE CROSS-BLUE CROSS
318900610MedicaidMI
KP062185OtherCHAMPUS-CHAMPUS
KP062185OtherCOMMERCIAL-COMMERCIAL NUMBER

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
062185MIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: kpatel12967@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1053489500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VA ANN ARBOR HEALTHCARE SYSTEM",
            "address_2": "2215 FULLER ROAD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-845-5290",
            "fax_number": "734-845-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA ANN ARBOR HEALTHCARE SYSTEM",
            "address_2": "2215 FULLER ROAD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-845-5290",
            "fax_number": "734-845-5288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Henry Ford Health System",
            "address_2": "2755 Carpenter Road",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48108",
            "country_code": "US",
            "telephone_number": "734-973-3090",
            "fax_number": "734-973-1470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KISHOR",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "062185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "700H262220",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318900610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "KP062185",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "KP062185",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.