Individual provider Active NPI

Dipesh B Patel, MD

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1093942682
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME114015 Issued in FL
Practice address
1095 N.W. St. Lucie West Blvd.
Port St. Lucie, FL 34986
Phone
(772) 785-5555
NPI assigned
Jun 22, 2009
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME114015 FL Primary

Addresses

Primary practice location

1095 N.W. St. Lucie West Blvd.
Port St. Lucie, FL 34986

Mailing address

3821 SW Coquina Cove Way
Apt. 204
Palm City, FL 34990
Phone (732) 781-8431

Other identifiers 2

IdentifierTypeStateIssuer
006395600MedicaidFL
14MP0OtherFLFLORIDA BLUE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dpatel27679@direct.martinhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20121003000434 FL Practitioner - Family Practice 8022267202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1095 NW Saint Lucie W Blvd
Suite 104
Port Saint Lucie, FL 34986
Phone (772) 785-5511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114015FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

1095 NW Saint Lucie West Blvd
Port St Lucie, FL 34986
Phone (772) 785-5500

1095 NW Saint Lucie West Blvd
#L
Port St Lucie, FL 34986
Phone (772) 785-5595

1095 NW Saint Lucie West Blvd
Ste 104
Port St Lucie, FL 34986
Phone (772) 785-5511

1095 NW Saint Lucie West Blvd
Ste 108
Port St Lucie, FL 34986
Phone (561) 785-5580

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: dpatel2500905@direct.ccf.org
  • Direct secure messaging: dpatel27679@direct.martinhealth.org

Organizations & group practices 2

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.

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1093942682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 SW COQUINA COVE WAY",
            "address_2": "APT. 204",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "34990",
            "telephone_number": "732-781-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 N.W. ST. LUCIE WEST BLVD.",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-785-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DIPESH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME114015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006395600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "14MP0",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpatel27679@direct.martinhealth.org",
            "affiliation": "N",
            "address_1": "1095 N.W. St. Lucie West Blvd.",
            "city": "Port St. Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "34986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.