Individual provider Active NPI

Dhara H Patel, PA-C

  • Physician Assistant
  • Livingston, NJ
National Provider Identifier
1235507542
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018903-1 Issued in NY
Practice address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone
(973) 322-5512
Fax
(973) 322-8165
NPI assigned
Sep 3, 2015
Last updated
Nov 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 018903-1 NY Primary

Addresses

Primary practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Mailing address

30B Vreeland Rd 200
Florham Park, NJ 07932-1926
Phone (973) 660-9334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210826001636 NY Practitioner - Physician Assistant 2163722208 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018903-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2021 Accepting new patients
Keystone Group, LLC Past Accepting new patients
American Anesthesiology of New Jersey, P.C. PastSince Jan 31, 2021 Accepting new patients

Locations

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/430a7ff7-9999-4cda-a19f-fb8b573704c8/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1235507542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30B VREELAND RD 200",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321926",
            "telephone_number": "973-660-9334",
            "fax_number": "973-660-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5512",
            "fax_number": "973-322-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHARA",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018903-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.