Individual provider Active NPI

Jalpa Patel, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1215661954
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12400 Issued in GA
Practice address
1220 Caroline St NE # a-230
Atlanta, GA 30307-2749
Phone
(678) 710-3980
NPI assigned
Jul 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12400 GA Primary
Physician Assistant 363A00000X NC

Addresses

Primary practice location

1220 Caroline St NE # a-230
Atlanta, GA 30307-2749

Mailing address

4864 Annelise Dr
Harrisburg, NC 28075-7649
Phone (704) 579-8398

Other practice location 1

4864 Annelise Dr
Harrisburg, NC 28075-7649
Phone (704) 579-8398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230614004036 NC Practitioner - Physician Assistant 8527426014 Reassigns benefits to 1 organization
I20240809001510 GA Practitioner - Physician Assistant 8527426014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1850 E W Connector
Austell, GA 30106-1246
Phone (770) 988-5824

209 Cooley Dr
Suite 101
Villa Rica, GA 30180-7057
Phone (770) 456-0911

3295 S Cobb Dr SE
Smyrna, GA 30080-4175
Phone (678) 723-6671

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2804
Phone (770) 222-8900

644 Thornton Rd
Lithia Springs, GA 30122-1518
Phone (678) 915-9887

9390 The Landing Dr
Douglasville, GA 30135-7180
Phone (770) 947-1112

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12400GAMDGeneral Practice Dentistry

Organizations & group practices 2

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": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1215661954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 ANNELISE DR",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757649",
            "telephone_number": "704-579-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CAROLINE ST NE # A-230",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072749",
            "telephone_number": "678-710-3980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4864 Annelise Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757649",
            "country_code": "US",
            "telephone_number": "704-579-8398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JALPA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-09",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12400",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.