Individual provider Active NPI

Kiranbhai Ramanbhai Patel, PA

  • Surgical Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1245758242
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
7777 Hennessy Blvd Ste 8001
Baton Rouge, LA 70808
Phone
(225) 490-7224
Fax
(225) 490-7223
NPI assigned
Aug 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 8001
Baton Rouge, LA 70808

Mailing address

7777 Hennessy Blvd Ste 8001
Baton Rouge, LA 70808-4300
Phone (225) 490-7224

Other practice location 1

7777 Hennessy Blvd Ste 1008
Baton Rouge, LA 70808-4368
Phone (225) 766-0416

Other practice location 2

7777 Hennessy Blvd Ste 1008
Baton Rouge, LA 70808-4368
Phone (225) 766-0416

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kpatel102054@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20171104000062 LA Practitioner - Physician Assistant 3678839826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 953-7800

7777 Hennessy Blvd
Baton Rouge, LA 70808-4300

7777 Hennessy Blvd
Baton Rouge, LA 70808-4363

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group, LLC CurrentSince Aug 19, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Aug 19, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC Physician Assistant Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1245758242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 8001",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-490-7224",
            "fax_number": "225-490-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 8001",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70808",
            "telephone_number": "225-490-7224",
            "fax_number": "225-490-7223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Hennessy Blvd Ste 1008",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084368",
            "country_code": "US",
            "telephone_number": "225-766-0416",
            "fax_number": "225-769-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7777 Hennessy Blvd Ste 1008",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084368",
            "country_code": "US",
            "telephone_number": "225-766-0416",
            "fax_number": "225-769-9212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KIRANBHAI",
        "middle_name": "RAMANBHAI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-30",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpatel102054@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kpatel102054@direct.casso.us.com",
            "address_1": "7777 Hennessy Blvd Ste 8001",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7777 Hennessy Blvd Ste 8001",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.