Individual provider Active NPI

Vimarsh Patel

  • Physician Assistant
  • Paramus, NJ
National Provider Identifier
1265911150
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MPO00485800 Issued in NJ
Practice address
300 Forest Ave
Paramus, NJ 07652-5429
Phone
(201) 490-5158
NPI assigned
Aug 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 25MPO00485800 NJ Primary

Addresses

Primary practice location

300 Forest Ave
Paramus, NJ 07652-5429

Mailing address

300 Forest Ave
Paramus, NJ 07652-5429

Other practice location 1

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20190104000749 NJ Practitioner - Physician Assistant 2567708019 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SKR Medical AdvisorsGroup PAC ID 7315185816, 18 clinicians
Hamilton Behavioral MD PAGroup PAC ID 8426294216, 31 clinicians
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

2100 88TH St
BLDG G1A
North Bergen, NJ 07047-4709
Phone (201) 773-1360

300 Forest Ave
A
Paramus, NJ 07652-5429
Phone (201) 490-5158

560 New York Ave
Lyndhurst, NJ 07071-1532
Phone (201) 345-3839

651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 979-1621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MPO00485800NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC Multi-Specialty Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1265911150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FOREST AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FOREST AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525429",
            "telephone_number": "201-490-5158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070552840",
            "country_code": "US",
            "telephone_number": "973-365-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VIMARSH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-10",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MPO00485800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.