Individual provider Active NPI

Jayanti N Patel, MD

  • Surgery Physician
  • Anaheim, CA
National Provider Identifier
1164512893
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A26621 Issued in CA
Practice address
1801 W Romneya Dr
Suite 405
Anaheim, CA 92801-1826
Phone
(714) 404-7602
Fax
(714) 974-5580
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A26621 CA
Surgery Physician 208600000X A26621 CA Primary

Addresses

Primary practice location

1801 W Romneya Dr
Suite 405
Anaheim, CA 92801-1826

Mailing address

PO Box 18867
Anaheim, CA 92817-8867
Phone (714) 404-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20121010000045 CA Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 4385893270 Reassigns benefits to 1 organization
Practice locations: Anaheim, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Mar 17, 2019 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

18035 Brookhurst St
Ste 1300
Fountain Valley, CA 92708
Phone (657) 241-9440

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24411 Health Center Dr
Ste 680
Laguna Hills, CA 92653
Phone (949) 268-4568

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1164512893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18867",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928178867",
            "telephone_number": "714-404-7602",
            "fax_number": "714-974-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W ROMNEYA DR",
            "address_2": "SUITE 405",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011826",
            "telephone_number": "714-404-7602",
            "fax_number": "714-974-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAYANTI",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A26621",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A26621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.