Individual provider Active NPI

Bhavi Patel

  • Psychiatric/Mental Health Nurse Practitioner
  • Jersey City, NJ
National Provider Identifier
1124646203
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
C-APN.0102275-C-NP Issued in CO
Practice address
111 Graham St
Jersey City, NJ 07307-3327
Phone
(201) 920-8901
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered Nurse 163WP0000X 26NR19682700 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0102275-C-NP CO Primary

Addresses

Primary practice location

111 Graham St
Jersey City, NJ 07307-3327

Mailing address

111 Graham St
Jersey City, NJ 07307-3327
Phone (201) 920-8901

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL iPhone Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260429001819 IL Practitioner - Nurse Practitioner 8921413139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ishine Behavioral Health IncGroup PAC ID 1850760919, 9 clinicians

Practice addresses (Care Compare)

2800 W Higgins Rd
Suite 650
Hoffman Estates, IL 60169-7268
Phone (815) 947-4463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR19682700NJMDPain Management Registered Nurse
C-APN.0102275-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1124646203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GRAHAM ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073073327",
            "telephone_number": "201-920-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GRAHAM ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073073327",
            "telephone_number": "201-920-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BHAVI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "NJ",
            "license": "26NR19682700",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0102275-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "iPhone",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 Graham St",
            "city": "Jersey City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "073073327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.