Individual provider Active NPI

Khusbu Patel, DPM

  • Podiatrist
  • Festus, MO
National Provider Identifier
1194389031
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2022025229 Issued in MO
Practice address
1455 US Highway 61 Ste a
Festus, MO 63028-4158
Phone
(636) 223-4639
NPI assigned
Apr 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2022025229 MO Primary

Addresses

Primary practice location

1455 US Highway 61 Ste a
Festus, MO 63028-4158

Mailing address

385 Tremont Ave
East Orange, NJ 07018-1023

Other practice location 1

385 Tremont Ave
East Orange, NJ 07018-1023
Phone (201) 936-4698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220809001616 MO Practitioner - Podiatry 2264814102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022025229MOMDPodiatrist

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1194389031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 US HIGHWAY 61 STE A",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284158",
            "telephone_number": "636-223-4639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 Tremont Ave",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070181023",
            "country_code": "US",
            "telephone_number": "201-936-4698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KHUSBU",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "2022025229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.