Individual provider Active NPI

Priyal Patel, M.D.

  • Family Medicine Physician
  • New Boston, TX
National Provider Identifier
1205220654
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8962 Issued in TX
Practice address
910 James Bowie Dr
New Boston, TX 75570-2335
Phone
(903) 614-5950
Fax
(903) 614-5965
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-10866 AR
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X R8962 TX Primary

Addresses

Primary practice location

910 James Bowie Dr
New Boston, TX 75570-2335

Mailing address

2900 Saint Michael Dr Ste 401
Texarkana, TX 75503-5211
Phone (903) 614-5392

Other practice location 1

3510 Richmond Rd
Texarkana, TX 75503-0714
Phone (903) 614-5220

Other identifiers 3

IdentifierTypeStateIssuer
200834030AMedicaidOK
3903395MedicaidTX
P02599458OtherTXRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180925003965 TX Practitioner - Family Practice 7214245703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

3502 Richmond Rd
Texarkana, TX 75503-0705
Phone (903) 614-5270

4824 McKnight Rd
Texarkana, TX 75503-0935
Phone (903) 614-5800

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Chambers Home Health Agency Home health agency, Texarkana, TX, CCN 747723
  • Christus Homecare - St Michael Home health agency, Texarkana, TX, CCN 679372
  • Encompass Health Home Health Home health agency, Texarkana, AR, CCN 047168
  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-10866ARMDEmergency Medicine Physician
R8962TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine CurrentSince Sep 27, 2018 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince Sep 27, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 1, 2020 Accepting new patients

Locations

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

910 James Bowie Dr
New Boston, TX 75570
Phone (903) 614-5950

2900 Saint Michael Dr
Ste 401
Texarkana, TX 75503
Phone (903) 614-5353

3510 Richmond Rd
Texarkana, TX 75503
Phone (903) 614-5220

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: priyal.patel.1@14285.direct.athenahealth.com
  • Direct secure messaging: ppatel232965@christushealth.direct-ci.net

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1205220654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT MICHAEL DR STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035211",
            "telephone_number": "903-614-5392",
            "fax_number": "903-614-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 JAMES BOWIE DR",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702335",
            "telephone_number": "903-614-5950",
            "fax_number": "903-614-5965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3510 Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755030714",
            "country_code": "US",
            "telephone_number": "903-614-5220",
            "fax_number": "903-614-5229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-10866",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R8962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200834030A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3903395",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P02599458",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Boston, TX

Sources for this page

Verify at the official NPI Registry.