Individual provider Active NPI

Sohil Mukesh Patel, PA-C

  • Medical Physician Assistant
  • Decatur, GA
National Provider Identifier
1093547259
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
12672 Issued in GA
Practice address
1829 Lawrenceville Hwy
Decatur, GA 30033-5728
Phone
(404) 292-8335
NPI assigned
Aug 16, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 12672 GA Primary

Addresses

Primary practice location

1829 Lawrenceville Hwy
Decatur, GA 30033-5728

Mailing address

5405 Village View LN
Stone Mountain, GA 30087-3166
Phone (706) 836-0117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241230002948 GA Practitioner - Physician Assistant 8426585621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1829 Lawrenceville Hwy
Decatur, GA 30033-5728
Phone (404) 292-8335

1834 Clairmont Rd
Suite 100
Decatur, GA 30033-3405
Phone (404) 634-4443

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2804
Phone (770) 222-8900

3991 Hwy 78 W
Snellville, GA 30039-3929
Phone (678) 786-8677

4072 Atlanta Hwy
Loganville, GA 30052-2297
Phone (678) 905-0236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12672GAMDMedical Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1093547259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 VILLAGE VIEW LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873166",
            "telephone_number": "706-836-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335728",
            "telephone_number": "404-292-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SOHIL",
        "middle_name": "MUKESH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "12672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.