Individual provider Active NPI

Krishna Patel

  • Physician Assistant
  • Old Bridge, NJ
National Provider Identifier
1083485346
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00827800 Issued in NJ
Practice address
1120 US Highway 9
Old Bridge, NJ 08857-2860
Phone
(732) 200-7800
NPI assigned
Jan 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00827800 NJ Primary

Addresses

Primary practice location

1120 US Highway 9
Old Bridge, NJ 08857-2860

Mailing address

15 Lavender Dr
Piscataway, NJ 08854-3593
Phone (732) 853-4154

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131004793 NJ Practitioner - Physician Assistant 9133572647 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Am PM Walk in Urgent Care ClinicGroup PAC ID 5092954602, 79 clinicians
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians
DRX Paramus, LLCGroup PAC ID 2466589585, 63 clinicians

Practice addresses (Care Compare)

19 S Washington Ave
Bergenfield, NJ 07621-2324
Phone (201) 387-0177

2 Journal Square PLZ
Suite a
Jersey City, NJ 07306-4001
Phone (551) 325-2333

352 Ryders LN
Milltown, NJ 08850-1706
Phone (732) 638-1990

4200 Bergenline Ave
Union City, NJ 07087-4924
Phone (551) 257-1948

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652-3623
Phone (201) 262-2010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00827800NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Am PM Primary Care Past Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients

Organizations & group practices 5

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": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1083485346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LAVENDER DR",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088543593",
            "telephone_number": "732-853-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 US HIGHWAY 9",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572860",
            "telephone_number": "732-200-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KRISHNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00827800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.