Active NPI
Kishor K. Patel, M.D.
- Internal Medicine Physician
- Ann Arbor, MI
National Provider Identifier
1053489500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 062185
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700H262220 | Other | BLUE CROSS-BLUE CROSS | |
| 318900610 | Medicaid | MI | |
| KP062185 | Other | CHAMPUS-CHAMPUS | |
| KP062185 | Other | COMMERCIAL-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
| License | State | Type | Specialty |
|---|---|---|---|
| 062185 | MI | MD | Internal Medicine Physician |
Interoperability endpoints
- 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.