Individual provider Active NPI

Nisha Bhupesh Patel, MD

  • Allergy & Immunology Physician
  • Atlanta, GA
National Provider Identifier
1073192324
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
113216 Issued in GA
Practice address
57 Executive Park S Ste 400
Atlanta, GA 30329-2249
Phone
(404) 778-3261
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 2025012240 MO
Allergy & Immunology Physician 207K00000X 113216 GA Primary
Internal Medicine Physician 207R00000X 113216 GA

Addresses

Primary practice location

57 Executive Park S Ste 400
Atlanta, GA 30329-2249

Mailing address

57 Executive Park S Ste 400
Atlanta, GA 30329-2249
Phone (404) 778-3261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20251022000573 MO Order and Referring Only - Allergy/ImmunologyPractitioner - Allergy/ImmunologyPractitioner - Internal Medicine 2567863509

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113216GAMDAllergy & Immunology Physician
2025012240MOMDAllergy & Immunology (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1073192324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 EXECUTIVE PARK S STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292249",
            "telephone_number": "404-778-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 EXECUTIVE PARK S STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292249",
            "telephone_number": "404-778-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHA",
        "middle_name": "BHUPESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "MO",
            "license": "2025012240",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "113216",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "113216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.