Individual provider Active NPI

Roshni Viren Patel, PA

  • Physician Assistant
  • Ocoee, FL
National Provider Identifier
1053948109
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113115 Issued in FL
Practice address
1540 Citrus Medical CT
Ocoee, FL 34761-4547
Phone
(407) 602-7168
Fax
(407) 245-8503
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113115 FL Primary

Addresses

Primary practice location

1540 Citrus Medical CT
Ocoee, FL 34761-4547

Mailing address

7512 Dr Phillips Blvd Ste 50
Orlando, FL 32819-5420
Phone (407) 602-7168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200417001241 FL Practitioner - Physician Assistant 1658701511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Adult Psychiatry LLC CurrentSince Apr 8, 2020 Accepting new patients

Locations

1540 Citrus Medical Ct
Ocoee, FL 34761
Phone (407) 245-8501

7512 Dr Phillips Blvd
Ste 50
Orlando, FL 32819
Phone (786) 375-1500

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1053948109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 DR PHILLIPS BLVD STE 50",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195420",
            "telephone_number": "407-602-7168",
            "fax_number": "407-245-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 CITRUS MEDICAL CT",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614547",
            "telephone_number": "407-602-7168",
            "fax_number": "407-245-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHNI",
        "middle_name": "VIREN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.