Jagruti Patel

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704178330 Issued in MI

Practice address

25710 Kelly Rd
Suite 3
Roseville, MI 48066-4959

Phone

(586) 772-2600

Fax

(586) 772-5289

NPI assigned

Dec 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Wings of Angel Home Health Care, LLC

  • Home Health Agency
  • Southfield, MI
  • NPI 1619030251
  NPD (past)

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1134584279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25710 KELLY RD",
            "address_2": "SUITE 3",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664959",
            "telephone_number": "586-772-2600",
            "fax_number": "586-772-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25710 KELLY RD",
            "address_2": "SUITE 3",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664959",
            "telephone_number": "586-772-2600",
            "fax_number": "586-772-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAGRUTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704178330",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704178330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Park, LMT
• Lindsey Parks-Plaza
• Rafael Pascual
• Latiece Jesstia Pasley
• Passion Driven Homecare Services LLC
• Patient Pathways Home Health Care LLC
• Patient Pathways Lab & Testing LLC
• John Patterson
• Paul Campbell DO PC
• Paul F Navarro D O P C

• Adult Health Nurse Practitioner in Roseville, MI
• Providers in Roseville, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.