Individual provider Active NPI

Vaibhaviben Patel

  • Nurse Practitioner
  • Burke, VA
National Provider Identifier
1245865609
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024179437 Issued in VA
Practice address
5774 Burke Towne CT
Burke, VA 22015-3136
Phone
(443) 799-9793
NPI assigned
Mar 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001218099 VA
Nurse Practitioner 363L00000X 0024179437 VA Primary

Addresses

Primary practice location

5774 Burke Towne CT
Burke, VA 22015-3136

Mailing address

5774 Burke Towne CT
Burke, VA 22015-3136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240523002957 DC Practitioner - Nurse Practitioner 7517309453 Reassigns benefits to 1 organization
I20250307001323 VA Practitioner - Nurse Practitioner 7517309453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Physiatry Consultants LLCGroup PAC ID 5698130771, 7 clinicians

Practice addresses (Care Compare)

14906 Richmond Hwy
Woodbridge, VA 22191-4016
Phone (732) 986-3795

8508 Queen Elizabeth Blvd
Annandale, VA 22003-4308
Phone (732) 986-3795

Hospital & facility affiliations

  • Stonesprings Hospital Center Hospital, Dulles, VA, CCN 490145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001218099VAMDRegistered Nurse
0024179437VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kinetic Medical Group CurrentSince Apr 17, 2024 Accepting new patients
Genesis Physiatry Consultants LLC CurrentSince Dec 29, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

14906 Richmond Hwy
Woodbridge, VA 22191
Phone (609) 335-6595

Organizations & group practices 3

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1245865609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5774 BURKE TOWNE CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5774 BURKE TOWNE CT",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153136",
            "telephone_number": "443-799-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VAIBHAVIBEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001218099",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024179437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

Verify at the official NPI Registry.