Individual provider Active NPI

Anjana M Patel, PA

  • Physician Assistant
  • Duluth, GA
National Provider Identifier
1285627505
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3782 Issued in GA
Practice address
3850 Pleasant Hill Rd
Duluth, GA 30096-4807
Phone
(770) 814-8222
Fax
(678) 205-5111
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3782 GA Primary

Addresses

Primary practice location

3850 Pleasant Hill Rd
Duluth, GA 30096-4807

Mailing address

3850 Pleasant Hill Rd
Duluth, GA 30096-4807
Phone (770) 814-8222

Other identifiers 5

IdentifierTypeStateIssuer
696237203FMedicaidGA
696237203AMedicaidGA
696237203EMedicaidGA
696237203BMedicaidGA
696237203DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070515000438 GA Practitioner - Physician Assistant 7113024886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta DermatologyGroup PAC ID 2163310533, 17 clinicians

Practice addresses (Care Compare)

3331 Hamilton Mill Rd
Suite 1106
Buford, GA 30519-7226
Phone (770) 814-8222

3370 Paddock Pkwy
Suwanee, GA 30024-9119
Phone (770) 814-8222

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3782GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: apatel@aadermaffiliates.emadirect.md

Organizations & group practices 1

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1285627505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964807",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964807",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANJANA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "3782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696237203F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696237203A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696237203E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696237203B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696237203D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.