Organization Active NPI

Ajay Patel, MD a Professional Medical Corporation

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Downey, CA
National Provider Identifier
1235593567
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A120793 Issued in CA
Legal business name
AJAY PATEL, MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
10441 Lakewood Blvd Ste E
Downey, CA 90241-2744
Phone
(562) 869-3585
Fax
(562) 869-3590
NPI assigned
Apr 13, 2016
Last updated
Jul 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Dr. Ajay Patel, MDNPI 1962636522
Title
Ceo
Phone
(909) 969-0513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X A120793 CA Primary

Addresses

Primary practice location

10441 Lakewood Blvd Ste E
Downey, CA 90241-2744

Mailing address

11525 Brookshire Ave
Suite 402
Downey, CA 90241-4985
Phone (562) 869-3585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160720001425 CA Part B Supplier - Clinic/Group Practice 5890088447 Receives reassigned benefits from 5 practitioners
Practice locations: Downey, CA

National Provider Directory

National Provider Directory

Locations

10441 Lakewood Blvd
Ste E
Downey, CA 90241
Phone (562) 869-3585

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1235593567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 BROOKSHIRE AVE",
            "address_2": "SUITE 402",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414985",
            "telephone_number": "562-869-3585",
            "fax_number": "562-869-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10441 LAKEWOOD BLVD STE E",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902412744",
            "telephone_number": "562-869-3585",
            "fax_number": "562-869-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJAY PATEL, MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-969-0513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A120793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.