Active NPI
Kinjal Ketan Patel
- Physical Therapist
- Tewksbury, MA
National Provider Identifier
1063125649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT6407
- Practice address
- 80 Winter LN
Tewksbury, MA 01876-2256 - Phone
- (978) 429-5412
- NPI assigned
- Dec 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT6407 | ME | Primary |
Addresses
Primary practice location
80 Winter LN
Tewksbury, MA 01876-2256
Mailing address
80 Winter LN
Tewksbury, MA 01876-2256
Phone (978) 429-5412
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT6407 | ME | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672185600000",
"number": "1063125649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 WINTER LN",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018762256",
"telephone_number": "978-429-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 WINTER LN",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018762256",
"telephone_number": "978-429-5412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KINJAL",
"middle_name": "KETAN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-28",
"last_updated": "2022-12-28",
"certification_date": "2022-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT6407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tewksbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.