Individual provider Active NPI

Deep Patel, DPM

  • Foot & Ankle Surgery Podiatrist
  • Raleigh, NC
National Provider Identifier
1265611560
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
548 Issued in NC
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

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
5915612MedicaidNC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001390 NC Practitioner - Podiatry 9739205600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.