Individual provider Active NPI

Nima Patel, PA-C

  • Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1215740980
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066387 Issued in PA
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001
Phone
(570) 808-7762
Fax
(570) 808-6128
NPI assigned
Jan 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA007171 PA
Physician Assistant 363A00000X MP9448627 PA
Physician Assistant 363A00000X MA066387 PA Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 808-7762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250619002412 PA Practitioner - Physician Assistant 5395256986 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA066387PAMDPhysician Assistant
OA007171PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Apr 10, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Apr 10, 2025 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Apr 10, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Apr 10, 2025 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

Organizations & group practices 7

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": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1215740980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-808-7762",
            "fax_number": "570-808-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110001",
            "telephone_number": "570-808-7762",
            "fax_number": "570-808-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA007171",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MP9448627",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.