Individual provider Active NPI

Kareena Vipul Patel

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1265189997
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115731
Practice address
4710 N Habana Ave
Tampa, FL 33614-7161
Phone
(813) 879-7940
NPI assigned
Mar 2, 2022
Reactivated
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 PA9115731 Primary

Addresses

Primary practice location

4710 N Habana Ave
Tampa, FL 33614-7161

Mailing address

1115 E Twiggs St Unit 902
Tampa, FL 33602-3175
Phone (843) 455-7122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1265189997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E TWIGGS ST UNIT 902",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023175",
            "telephone_number": "843-455-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147161",
            "telephone_number": "813-879-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAREENA",
        "middle_name": "VIPUL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "deactivation_date": "2022-03-05",
        "reactivation_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PA9115731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.