Individual provider Active NPI

Depen Patel, D.O.

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1336559079
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101023451 Issued in MI
Practice address
1202 Martin Luther King Jr Way
Tacoma, WA 98405-3926
Phone
(253) 441-4742
NPI assigned
May 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WA
Family Medicine Physician 207Q00000X 5101023451 MI Primary

Addresses

Primary practice location

1202 Martin Luther King Jr Way
Tacoma, WA 98405-3926

Mailing address

1202 Martin Luther King Jr Way
Tacoma, WA 98405-3926
Phone (253) 441-4742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240401001855 IL Practitioner - Family Practice 9436465093 Reassigns benefits to 1 organization
I20240510002463 CA Practitioner - Family Practice 9436465093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6469OKMDDentist
18121CAMDMechanotherapist
5101023451MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RPM Care Coordination, PC Family Medicine CurrentSince Jan 14, 2024 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Cloud Health Medical Group of California, P.C. Family Medicine Past Accepting new patients

Locations

507 S Douglas St
Fl 3
El Segundo, CA 90245

1100 Glendon Ave
Ste 1555
Los Angeles, CA 90024
Phone (669) 342-9449

1500 N Halsted St
Fl 2
Chicago, IL 60642
Phone (312) 762-5335

159 N Sangamon St
Ste 200
Chicago, IL 60607
Phone (312) 549-8076

Organizations & group practices 3

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": "1399075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1336559079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053926",
            "telephone_number": "253-441-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053926",
            "telephone_number": "253-441-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DEPEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-03",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101023451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.