Active NPI
Ketan C Patel, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Medford, MA
National Provider Identifier
1366755589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PCT0010042
- Practice address
- 467 Salem St
Medford, MA 02155-3336 - Phone
- (617) 653-9904
- NPI assigned
- Jul 16, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH25938 | MA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PCT0010042 | CT | Primary |
Addresses
Primary practice location
467 Salem St
Medford, MA 02155-3336
Mailing address
P.O. Box 690068
Quincy, MA 02269
Phone (617) 653-9904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH25938 | MA | MD | Pharmacist |
| PCT0010042 | CT | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279238400000",
"number": "1366755589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 690068",
"city": "QUINCY",
"state": "MA",
"postal_code": "02269",
"telephone_number": "617-653-9904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "467 SALEM ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021553336",
"telephone_number": "617-653-9904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KETAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-16",
"last_updated": "2010-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH25938",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CT",
"license": "PCT0010042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.