Individual provider Active NPI

Nina Samir Patel, DDS.

  • General Practice Dentistry
  • Floral Park, NY
National Provider Identifier
1316917032
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048437-1 Issued in NY
Practice address
22 S Tyson Ave
Floral Park, NY 11001-2017
Phone
(516) 355-0155
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 048437-1 NY Primary

Addresses

Primary practice location

22 S Tyson Ave
Floral Park, NY 11001-2017

Mailing address

22 S Tyson Ave
2ND Floor
Floral Park, NY 11001-2017
Phone (516) 355-0155

Other identifiers 1

IdentifierTypeStateIssuer
02187988MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160623000005 NY Order and Referring Only - DentistPractitioner - Dentist 3274824206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048437-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr.Nina S. Patel DDS., P.C. General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1316917032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S TYSON AVE",
            "address_2": "2ND FLOOR",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012017",
            "telephone_number": "516-355-0155",
            "fax_number": "516-355-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S TYSON AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110012017",
            "telephone_number": "516-355-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NINA",
        "middle_name": "SAMIR",
        "name_prefix": "Mrs.",
        "credential": "DDS.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048437-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187988",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

Verify at the official NPI Registry.