Individual provider Active NPI

Raj Patel

  • Emergency Medicine Physician
  • Summit, NJ
National Provider Identifier
1063162451
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB12703900 Issued in NJ
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(908) 522-2232
NPI assigned
Mar 28, 2022
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB12703900 NJ Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

5612 Lake Trace Dr
Hoover, AL 35244-3967
Phone (205) 261-1484

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815002246 NJ Practitioner - Emergency Medicine 6901305168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of North Jersey P CGroup PAC ID 7911992326, 125 clinicians

Practice addresses (Care Compare)

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-2232

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB12703900NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Jul 22, 2025 Accepting new patients

Locations

1 Hospital Plz
Old Bridge, NJ 08857
Phone (732) 324-4158

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1063162451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5612 LAKE TRACE DR",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443967",
            "telephone_number": "205-261-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-2232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RAJ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB12703900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.