Individual provider Active NPI

Amy M. Patel, PA-C

  • Physician Assistant
  • Statesville, NC
National Provider Identifier
1104177203
Registry record updated Feb 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008403 Issued in MD
Practice address
557 Brookdale Dr
Statesville, NC 28677-4107
Phone
(704) 873-5661
NPI assigned
Sep 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03819 NC
Physician Assistant 363A00000X C0008403 MD Primary

Addresses

Primary practice location

557 Brookdale Dr
Statesville, NC 28677-4107

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-2704

Other practice location 1

8600 Old Georgetown Rd
Bethesda, MD 20814-1422
Phone (301) 896-2578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190919000148 DC Practitioner - Physician Assistant 6204088222 Reassigns benefits to 3 organizations
I20220207000193 MD Practitioner - Physician Assistant 6204088222 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0008403MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jan 25, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Dec 13, 2025 Accepting new patients
Johns Hopkins University CurrentSince Jan 25, 2024 Accepting new patients
WHC Emerg Phys CurrentSince May 18, 2020 Accepting new patients
Johns Hopkins University CurrentSince Dec 13, 2025 Accepting new patients
WHC Physician Group LLC CurrentSince May 18, 2020 Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Past Accepting new patients
Edwin J Lee MD PC Past Accepting new patients
Observation Medicine Physicians of Mecklenburg County PLLC Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

600 N Wolfe St
Baltimore, MD 21287

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

Interoperability endpoints

  • Direct secure messaging: apatel1169713@direct.hopkinsmedicine.org

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1104177203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "704-873-5661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8600 Old Georgetown Rd",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208141422",
            "country_code": "US",
            "telephone_number": "301-896-2578",
            "fax_number": "301-897-1378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMY",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03819",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.