Individual provider Active NPI

Roshni Patel, DMD

  • Dentist
  • Port Saint Lucie, FL
National Provider Identifier
1255782629
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21970 Issued in FL
Practice address
10457 S US Highway 1
Port Saint Lucie, FL 34952-5645
Phone
(772) 446-4816
NPI assigned
Jun 28, 2016
Last updated
Feb 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21970 FL Primary

Addresses

Primary practice location

10457 S US Highway 1
Port Saint Lucie, FL 34952-5645

Mailing address

10457 S US Highway 1
Port Saint Lucie, FL 34952-5645
Phone (772) 446-4816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170220002875 FL Order and Referring Only - DentistPractitioner - Dentist 0941583835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1255782629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10457 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525645",
            "telephone_number": "772-446-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10457 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525645",
            "telephone_number": "772-446-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHNI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.