Individual provider Active NPI

Jayantibhai Patel, M.D.

  • Neurology Physician
  • Chandler, AZ
National Provider Identifier
1366444341
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
28930 Issued in AZ
Practice address
2979 W Elliot Rd
Suite 2
Chandler, AZ 85224-1641
Phone
(480) 615-7800
Fax
(480) 615-7803
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 28930 AZ
Neurology Physician 2084N0400X 28930 AZ Primary

Addresses

Primary practice location

2979 W Elliot Rd
Suite 2
Chandler, AZ 85224-1641

Mailing address

2979 W Elliot Rd
Suite 2
Chandler, AZ 85224-1641
Phone (480) 615-7800

Other identifiers 4

IdentifierTypeStateIssuer
1Z0871OtherAZHEALTHNET ID
557803MedicaidAZ
5085187OtherAZAETNA INSURANCE
AZ0881440OtherAZBCBS PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040817000011 AZ Practitioner - Neurology 8628041837

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28930AZMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1366444341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 W ELLIOT RD",
            "address_2": "SUITE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241641",
            "telephone_number": "480-615-7800",
            "fax_number": "480-615-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 W ELLIOT RD",
            "address_2": "SUITE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241641",
            "telephone_number": "480-615-7800",
            "fax_number": "480-615-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAYANTIBHAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "28930",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "28930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID",
            "identifier": "1Z0871",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "557803",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "5085187",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "AZ0881440",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.