Individual provider Active NPI

Dipa Rohit Patel

  • Physician Assistant
  • Elkridge, MD
National Provider Identifier
1104541176
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008652 Issued in MD
Practice address
5429 Forest Kelly CT
Elkridge, MD 21075-1010
Phone
(443) 687-4739
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C0008652 MD
Physician Assistant 363A00000X C0008652 MD Primary

Addresses

Primary practice location

5429 Forest Kelly CT
Elkridge, MD 21075-1010

Mailing address

5429 Forest Kelly CT
Elkridge, MD 21075-1010
Phone (443) 687-4739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20221227001136 MD Practitioner - Physician Assistant 9537539028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2002 Medical Pkwy
Suite 230
Annapolis, MD 21401-3282
Phone (410) 266-3900

23 Crossroads Dr
Suite 400
Owings Mills, MD 21117-5490
Phone (410) 356-2626

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0008652MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group, PA Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Centennial Medical Group, PA CurrentSince Dec 1, 2022 Accepting new patients
Annapolis ENT Surgical Center, LLC Past Accepting new patients

Locations

6230 Old Dobbin Ln
Ste 230
Columbia, MD 21045
Phone (443) 312-2111

10981 Johns Hopkins Rd
Laurel, MD 20723
Phone (410) 694-7999

Organizations & group practices 5

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1104541176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 FOREST KELLY CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210751010",
            "telephone_number": "443-687-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 FOREST KELLY CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210751010",
            "telephone_number": "443-687-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DIPA",
        "middle_name": "ROHIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "C0008652",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.