NPIMap

Individual provider Active NPI

Gunjan Kanaiyalal Patel, DO

  • Family Medicine Physician
  • Apex, NC
National Provider Identifier
1093395519
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LL83501 Issued in SC
Practice address
1481 Richardson Rd Ste 118
Apex, NC 27523-8073
Phone
(919) 385-5650
Fax
(919) 385-9341
NPI assigned
Apr 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X LL83501 SC Primary

Addresses

Primary practice location

1481 Richardson Rd Ste 118
Apex, NC 27523-8073

Mailing address

1481 Richardson Rd Ste 118
Apex, NC 27523-8073
Phone (919) 385-5650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008004497 NC Practitioner - Family Practice 3678976958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1565 Orchard Villas Ave
Apex, NC 27502-4321
Phone (919) 367-9355

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL83501SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Duke University Affiliated Physicians, Inc. Single Specialty Current Accepting new patients
Duke University Affliated Physicians, Inc Family Medicine CurrentSince Oct 7, 2024 Accepting new patients
Duke University Affiliated Physicians, Inc. Single Specialty PastSince Oct 20, 2024 Accepting new patients
Private Diagnostic Clinic, PLLC Single Specialty PastSince Oct 7, 2024 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Past Accepting new patients

Locations

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Interoperability endpoints

  • Direct secure messaging: gpatel604591@direct.medicine.duke.edu

Organizations & group practices 6

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 6

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1093395519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 RICHARDSON RD STE 118",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275238073",
            "telephone_number": "919-385-5650",
            "fax_number": "919-385-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 RICHARDSON RD STE 118",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275238073",
            "telephone_number": "919-385-5650",
            "fax_number": "919-385-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "GUNJAN",
        "middle_name": "KANAIYALAL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL83501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

Verify at the official NPI Registry.