Individual provider Active NPI

Sandhya D Patel, MD

  • Pediatrics Physician
  • Bingham Farms, MI
National Provider Identifier
1063403103
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301067891 Issued in MI
Practice address
31500 Telegraph Rd
Ste 105
Bingham Farms, MI 48025-4367
Phone
(248) 540-8700
Fax
(248) 540-8701
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301067891 MI Primary

Addresses

Primary practice location

31500 Telegraph Rd
Ste 105
Bingham Farms, MI 48025-4367

Mailing address

31500 Telegraph Rd
Ste 105
Bingham Farms, MI 48025-4367
Phone (248) 540-8700

Other identifiers 1

IdentifierTypeStateIssuer
4100425MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20201201002512 MI Practitioner - Pediatric Medicine 0446661102 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301067891MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince Nov 19, 2020 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Organizations & group practices 2

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1063403103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31500 TELEGRAPH RD",
            "address_2": "STE 105",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254367",
            "telephone_number": "248-540-8700",
            "fax_number": "248-540-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 TELEGRAPH RD",
            "address_2": "STE 105",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254367",
            "telephone_number": "248-540-8700",
            "fax_number": "248-540-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SANDHYA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301067891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4100425",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

Verify at the official NPI Registry.