Individual provider Active NPI

Jaymin Rajnikant Patel, MD

  • Vascular & Interventional Radiology Physician
  • Lawrenceville, GA
National Provider Identifier
1063497006
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
36064 Issued in GA
Practice address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone
(678) 312-4440
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 36064 GA
Vascular & Interventional Radiology Physician 2085R0204X 36064 GA Primary

Addresses

Primary practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Mailing address

PO Box 1746
Indianapolis, IN 46206-1746
Phone (877) 383-4442

Other identifiers 2

IdentifierTypeStateIssuer
000707231MedicaidGA
P00121310OtherGARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040310000345 GA Practitioner - Diagnostic Radiology 8527956572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at San Antonio, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Metropolitan Radiology Associates LLPGroup PAC ID 7214825561, 45 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (770) 237-1428

2078 Teron Trce
Suite 200
Dacula, GA 30019-1606
Phone (678) 312-8600

3620 Howell Ferry Rd
Duluth, GA 30096-3178
Phone (678) 312-6800

3805 Pleasant Hill Rd
Duluth, GA 30096-4808
Phone (678) 312-7316

631 Professional Dr
Suite 250
Lawrenceville, GA 30046-3370
Phone (678) 312-0900

Hospital & facility affiliations

  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Merit-based Incentive Payment System (MIPS)

Final score
85.01 of 100Reported as group
Quality
90
Improvement activities
40
Cost
68.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Metropolitan Radiology Associates, LLP Diagnostic Radiology CurrentSince Jan 1, 2004 Accepting new patients
Radiology Associates of Columbus PC Diagnostic Radiology Past Accepting new patients
Johns Creek Diagnostic Center, LLC Past Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1063497006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1746",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061746",
            "telephone_number": "877-383-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAYMIN",
        "middle_name": "RAJNIKANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "36064",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "36064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000707231",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00121310",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.