Individual provider Active NPI

Ishita Patel, PA.C

  • Physician Assistant
  • Wyomissing, PA
National Provider Identifier
1265722730
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056136 Issued in PA
Practice address
2 Meridian Blvd
Wyomissing, PA 19610
Phone
(610) 743-3139
Fax
(610) 743-3143
NPI assigned
Apr 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014672 NY
Physician Assistant 363A00000X MA056136 PA Primary

Addresses

Primary practice location

2 Meridian Blvd
Wyomissing, PA 19610

Mailing address

2500 Bernville Rd
Reading, PA 19605-9453
Phone (610) 743-3137

Other names 1

  • Ishita Thakkar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140807001497 PA Practitioner - Physician Assistant 6507083961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence I Katin MD PCGroup PAC ID 7719026582, 4 clinicians

Practice addresses (Care Compare)

11 Industrial Blvd
Suite 102
Paoli, PA 19301-1620
Phone (610) 647-6070

Hospital & facility affiliations

  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Bryn Mawr Rehabilitation Hospital Inpatient rehabilitation facility, Malvern, PA, CCN 393025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014672NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence I Katin MD Past Accepting new patients

Organizations & group practices 2

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 4

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1265722730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BERNVILLE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196059453",
            "telephone_number": "610-743-3137",
            "fax_number": "610-743-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MERIDIAN BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "19610",
            "telephone_number": "610-743-3139",
            "fax_number": "610-743-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ISHITA",
        "credential": "PA.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014672",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISHITA",
            "last_name": "THAKKAR",
            "credential": "R. PA.C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.