Individual provider Active NPI

Ishani Patel, PA

  • Physician Assistant
  • Tinley Park, IL
National Provider Identifier
1174842926
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone
(708) 226-7000
Fax
(708) 226-7174
NPI assigned
May 19, 2010
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

17495 La Grange Rd
Tinley Park, IL 60487-7581

Mailing address

820 Springer Dr
Lombard, IL 60148-6413
Phone (708) 634-4602

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
I20130614000060 IL Practitioner - Physician Assistant 3577757624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

1124 Essington Rd
Suite a
Joliet, IL 60435-8442
Phone (815) 744-8554

2500 S Highland Ave
Suite 320
Lombard, IL 60148-5390
Phone (815) 744-8554

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients
Pinnacle Dermatology, SC PastSince Sep 28, 2021 Accepting new patients
Dermatology and Plastic Surgery Associates, S.C. PastSince Mar 1, 2004 Accepting new patients
The Dermatology Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ipatel@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1174842926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "708-634-4602",
            "fax_number": "630-495-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17495 LA GRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877581",
            "telephone_number": "708-226-7000",
            "fax_number": "708-226-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ISHANI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.