Individual provider Active NPI

Monal Patel

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1245841451
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9811 Issued in GA
Practice address
8095 Roswell Rd
Atlanta, GA 30350-3931
Phone
(404) 786-8581
NPI assigned
Aug 11, 2020
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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 9811 GA Primary

Addresses

Primary practice location

8095 Roswell Rd
Atlanta, GA 30350-3931

Mailing address

5575 Fords Crossing CT NW
Acworth, GA 30101-4806
Phone (804) 387-6839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20201222000628 GA Practitioner - Physician Assistant 9032521778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Urgent Care Holding LLCGroup PAC ID 4587984695, 77 clinicians

Practice addresses (Care Compare)

11685 Alpharetta Hwy
Suite 150a
Roswell, GA 30076-4982
Phone (770) 555-5555

81 Northside Dawson Dr
Suite 100a
Dawsonville, GA 30534-7166
Phone (706) 216-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9811GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Plus Primary Care LLC PastSince Aug 23, 2020 Accepting new patients

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, 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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1245841451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 FORDS CROSSING CT NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014806",
            "telephone_number": "804-387-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303503931",
            "telephone_number": "404-786-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MONAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.