Active NPI
Jemin V Patel, D.M.D
- General Practice Dentistry
- Harrisburg, PA
National Provider Identifier
1154473783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS035041
- Practice address
- 852 S 16TH St
Harrisburg, PA 17104-2611 - Phone
- (717) 232-2237
- Fax
- (717) 909-0640
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS035041 | PA | Primary |
Addresses
Primary practice location
852 S 16TH St
Harrisburg, PA 17104-2611
Mailing address
852 S 16TH St
Harrisburg, PA 17104-2611
Phone (717) 232-2237
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015678820001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160706001361 | PA | Order and Referring Only - Dentist | 9931491396 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paxton Dental Care P.C. | General Practice | Past | Accepting new patients |
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": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1154473783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "852 S 16TH ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171042611",
"telephone_number": "717-232-2237",
"fax_number": "717-909-0640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "852 S 16TH ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171042611",
"telephone_number": "717-232-2237",
"fax_number": "717-909-0640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JEMIN",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS035041",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015678820001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.