Individual provider Active NPI

Khyati Patel, PSYD

  • Clinical Psychologist
  • Monroe, MI
National Provider Identifier
1285323097
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362009268 Issued in MI
Practice address
650 Stewart Rd
Monroe, MI 48162-4222
Phone
(734) 240-8430
NPI assigned
May 8, 2023
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6362009268 MI Primary

Addresses

Primary practice location

650 Stewart Rd
Monroe, MI 48162-4222

Mailing address

650 Stewart Rd
Monroe, MI 48162-4222
Phone (734) 240-8430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010003336 MI Practitioner - Clinical Psychologist 2769837806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6650 Stewart Rd
Monroe, MI 48162-9680
Phone (734) 240-8430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6362009268MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Memorial Hospital Corporation CurrentSince Sep 4, 2023 Accepting new patients
Mercy Memorial Hospital Corporatio CurrentSince Sep 4, 2023 Accepting new patients

Locations

650 Stewart Rd
Monroe, MI 48162
Phone (734) 240-4594

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

905 N Macomb St
Ste 2
Monroe, MI 48162
Phone (734) 242-1899

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1285323097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624222",
            "telephone_number": "734-240-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624222",
            "telephone_number": "734-240-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KHYATI",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.