Individual provider Active NPI

Raj Ashok Patel, MD

  • Vascular & Interventional Radiology Physician
  • Leland, NC
National Provider Identifier
1114412475
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
2024-01151 Issued in NC
Practice address
1176 E Cutlar Xing Ste 200
Leland, NC 28451-6426
Phone
(703) 783-5353
NPI assigned
Jun 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN27315 FL
Student in an Organized Health Care Education/Training Program 390200000X CT
Vascular & Interventional Radiology Physician 2085R0204X 2024-01151 NC Primary
Diagnostic Radiology Physician 2085R0202X 2024-01151 NC

Addresses

Primary practice location

1176 E Cutlar Xing Ste 200
Leland, NC 28451-6426

Mailing address

1176 E Cutlar Xing Ste 200
Leland, NC 28451-6426

Other practice location 1

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240627004256 NC Practitioner - Interventional Radiology 2668709320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
University of South Florida College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Associates of Southeastern North Carolina PAGroup PAC ID 5092601872, 9 clinicians

Practice addresses (Care Compare)

1176 E Cutlar Xing
Suite C
Leland, NC 28451-6426
Phone (919) 741-4435

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-01151NCMDDiagnostic Radiology Physician
TRN27315FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of Southeastern North Carolina, PA CurrentSince Jul 15, 2024 Accepting new patients

Locations

1905 Glen Meade Rd
Wilmington, NC 28403
Phone (910) 762-3547

Interoperability endpoints

  • Direct secure messaging: rpatel427326@direct.ynhh.org

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1114412475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 E CUTLAR XING STE 200",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 E CUTLAR XING STE 200",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516426",
            "telephone_number": "703-783-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RAJ",
        "middle_name": "ASHOK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN27315",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NC",
            "license": "2024-01151",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2024-01151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.