Individual provider Active NPI

Kanika Jayesh Patel

  • Pharmacy
  • Wakefield, MA
National Provider Identifier
1093319501
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PH239738 Issued in MA
Practice address
451 Main St
Wakefield, MA 01880-3354
Phone
(781) 245-2270
NPI assigned
Nov 24, 2020
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH239738 MA Primary

Addresses

Primary practice location

451 Main St
Wakefield, MA 01880-3354

Mailing address

451 Main St
Wakefield, MA 01880-3354
Phone (781) 245-2270

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

LicenseStateTypeSpecialty
PH239738MAMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc Pharmacy PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 1

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": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1093319501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803354",
            "telephone_number": "781-245-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803354",
            "telephone_number": "781-245-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KANIKA",
        "middle_name": "JAYESH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MA",
            "license": "PH239738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.