NPIMap

Organization Active NPI

Kashyap Patel MD PA

Doing business as A-one family Practice

  • Family Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1114037462
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME90826 Issued in FL
Legal business name
KASHYAP PATEL MD PA
Doing business as
A-one family Practice
Practice address
325 Clyde Morris Blvd Ste 340
Ormond Beach, FL 32174-3199
Phone
(386) 615-8971
Fax
(386) 677-9685
NPI assigned
Aug 30, 2006
Last updated
Jan 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Authorized official

Name
Kashyap Patel, M.D.NPI 1982630042
Title
President
Phone
(386) 615-8971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME90826 FL Primary

Addresses

Primary practice location

325 Clyde Morris Blvd Ste 340
Ormond Beach, FL 32174-3199

Mailing address

325 Clyde Morris Blvd Ste 340
Ormond Beach, FL 32174-3199
Phone (386) 615-8971

Other identifiers 1

IdentifierTypeStateIssuer
270963500MedicaidFL

Other names 1

  • A-one family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041109000902 FL Part B Supplier - Clinic/Group Practice 9830152974 Receives reassigned benefits from 20 practitioners
Practice locations: South Daytona, FL; Daytona Beach, FL; Ormond Beach, FL; Holly Hill, FL; Bunnell, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1032064A One Family Practice325 Clyde Morris Blvd Ste 340, Ormond Beach, FL 32174Certificate of waiverDec 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Inland Imaging PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

170 N Old Kings Rd
Ormond Beach, FL 32174
Phone (386) 615-8139

325 Clyde Morris Blvd
Ste 340
Ormond Beach, FL 32174
Phone (386) 615-8971

598 Sterthaus Dr
#C
Ormond Beach, FL 32174
Phone (386) 672-9683

25 Palm Harbor Village Way
Ste 2
Palm Coast, FL 32137

322 Big Tree Rd
South Daytona, FL 32119
Phone (386) 310-8745

Practitioners & affiliated clinicians

Practitioners 80

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1114037462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 CLYDE MORRIS BLVD STE 340",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743199",
            "telephone_number": "386-615-8971",
            "fax_number": "386-677-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CLYDE MORRIS BLVD STE 340",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743199",
            "telephone_number": "386-615-8971",
            "fax_number": "386-677-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KASHYAP PATEL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KASHYAP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-615-8971",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME90826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270963500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A-one family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.