Active NPI
Kavina Patel
- Dermatology Physician
- Phoenix, AZ
National Provider Identifier
1205417599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 79162
- Practice address
- 1331 N 7TH St Ste 250
Phoenix, AZ 85006-2722 - Phone
- (602) 483-6504
- Fax
- (602) 354-5607
- NPI assigned
- Apr 18, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 79162 | AZ | Primary |
Addresses
Primary practice location
1331 N 7TH St Ste 250
Phoenix, AZ 85006-2722
Mailing address
1331 N 7TH St Ste 250
Phoenix, AZ 85006-2722
Phone (602) 483-6504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5310 Harvest Hill Rd
Suite 290
Dallas, TX 75230-5801
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79162 | AZ | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1205417599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 N 7TH ST STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062722",
"telephone_number": "602-483-6504",
"fax_number": "602-354-5607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 N 7TH ST STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062722",
"telephone_number": "602-483-6504",
"fax_number": "602-354-5607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KAVINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-18",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "AZ",
"license": "79162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.