Individual provider Active NPI

Hemant Dasharathlal Patel, PT

  • Physical Therapist
  • St Augustine, FL
National Provider Identifier
1326068586
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29148 Issued in FL
Practice address
105 Southpark Blvd Ste B201
Saint Augustine, FL 32086-5159
Phone
(904) 824-1636
Fax
(904) 824-7488
NPI assigned
Jul 20, 2006
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011729 GA
Physical Therapist 225100000X 05008811A IN
Physical Therapist 225100000X 027205 NY
Physical Therapist 225100000X PT29148 FL Primary

Addresses

Primary practice location

105 Southpark Blvd Ste B201
Saint Augustine, FL 32086-5159

Mailing address

105 Southpark Blvd Ste B201
Saint Augustine, FL 32086-5159
Phone (904) 824-1636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150218001158 GA Practitioner - Physical Therapist in Private Practice 2163513482 Reassigns benefits to 1 organization
I20200420002538 FL Practitioner - Physical Therapist in Private Practice 2163513482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Associates of Orange Park, IncGroup PAC ID 0042287237, 2 clinicians

Practice addresses (Care Compare)

1845 Eastwest Pkwy
Suite 14And15
Fleming Island, FL 32003-6405
Phone (904) 264-6304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT29148FLMDPhysical Therapist
PT011729GAMDPhysical Therapist
05008811AINMDPhysical Therapist
027205NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist CurrentSince Sep 28, 2014 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist CurrentSince Sep 28, 2014 Accepting new patients
Physical Therapy Associates of Orange Park, Inc CurrentSince Jan 22, 2023 Accepting new patients
Physical Therapy Associates of Orange Park, Inc Physical Therapist CurrentSince Mar 5, 2020 Accepting new patients
Uniq Therapy Services Inc Physical Therapist Current Accepting new patients
SRN Chiropractic, PC Past Accepting new patients
Rebound Rehabilitative Services Inc Past Accepting new patients
Rebound Rehabilitative Services Inc PastSince May 31, 2020 Accepting new patients
Rebound Rehabilitative Services Inc Physical Therapist PastSince Dec 21, 2024 Accepting new patients
Rebound Rehabilitative Services Inc Physical Therapist PastSince Sep 15, 2024 Accepting new patients
I.E.S. Medical, PC Past Accepting new patients
White Medical, PC Past Accepting new patients

Locations

1845 Eastwest Pkwy
Ste 1415
Fleming Isle, FL 32003
Phone (904) 264-6301

280 Dundas Dr
Ste B
Jacksonville, FL 32218
Phone (904) 420-0110

151 College Dr
Ste 10
Orange Park, FL 32065
Phone (904) 264-6304

1550 Business Center Dr
Ste B
Orange Park, FL 32003
Phone (904) 264-6304

7423 Adairsville Hwy
Adairsville, GA 30103
Phone (770) 373-9315

1000 Johnson Ferry Rd
Ste A115
Marietta, GA 30068
Phone (404) 367-2085

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1326068586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD STE B201",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865159",
            "telephone_number": "904-824-1636",
            "fax_number": "904-824-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD STE B201",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865159",
            "telephone_number": "904-824-1636",
            "fax_number": "904-824-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HEMANT",
        "middle_name": "DASHARATHLAL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011729",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008811A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027205",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT29148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.