Active NPI
Rajkumar Patel, BSC
- Pharmacist
- Longwood, FL
National Provider Identifier
1063708493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS33057
- Practice address
- 130 E State Road 434
Longwood, FL 32750-5214 - Phone
- (407) 332-8384
- NPI assigned
- Jun 23, 2011
- Last updated
- Feb 2, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS33057 | FL | Primary |
Addresses
Primary practice location
130 E State Road 434
Longwood, FL 32750-5214
Mailing address
130 E State Road 434 # T0649
Longwood, FL 32750-5214
Phone (407) 332-8384
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS33057 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.cvs.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| PS33057 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1063708493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 E STATE ROAD 434 # T0649",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327505214",
"telephone_number": "407-332-8384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 E STATE ROAD 434",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327505214",
"telephone_number": "407-332-8384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "RAJKUMAR",
"name_prefix": "Mr.",
"credential": "BSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-23",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS33057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS33057",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.cvs.com",
"affiliation": "N",
"endpointDescription": "website",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "130 E State Road 434",
"city": "Longwood",
"state": "FL",
"country_code": "US",
"postal_code": "327505214",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.