Active NPI
Deep Patel, DPM
- Foot & Ankle Surgery Podiatrist
- Raleigh, NC
National Provider Identifier
1265611560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 548
- Practice address
- 1514 Glenwood Ave
Raleigh, NC 27608-2368 - Phone
- (919) 829-0076
- Fax
- (919) 836-9094
- NPI assigned
- Nov 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 548 | NC | Primary |
Addresses
Primary practice location
1514 Glenwood Ave
Raleigh, NC 27608-2368
Mailing address
1514 Glenwood Ave
Raleigh, NC 27608-2368
Phone (919) 829-0076
Other practice location 1
1514 Glenwood Ave
Raleigh, NC 27608-2368
Phone (336) 655-6409
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5915612 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100928001390 | NC | Practitioner - Podiatry | 9739205600 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- deeppatel@cfaac-nc.direct.office.nextgen.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1265611560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 GLENWOOD AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276082368",
"telephone_number": "919-829-0076",
"fax_number": "919-942-0038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 GLENWOOD AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276082368",
"telephone_number": "919-829-0076",
"fax_number": "919-836-9094"
}
],
"practiceLocations": [
{
"address_1": "1514 Glenwood Ave",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276082368",
"country_code": "US",
"telephone_number": "336-655-6409",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "DEEP",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-02",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NC",
"license": "548",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5915612",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.