Individual provider Active NPI

Archanaben C Patel, PA-C

  • Medical Physician Assistant
  • Clermont, FL
National Provider Identifier
1386017994
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109257 Issued in FL
Practice address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone
(352) 536-8840
Fax
(352) 536-8841
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109257 FL Primary

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

Other identifiers 1

IdentifierTypeStateIssuer
016876400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160413000628 FL Practitioner - Physician Assistant 7719285493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1900 Don Wickham Dr
Clermont, FL 34711-1979

1920 Don Wickham Dr
Clermont, FL 34711-1918
Phone (407) 351-5384

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Mar 9, 2016 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

587 E State Road 434
Longwood, FL 32750
Phone (407) 896-1100

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: apatel30972@orlandohealth.medalliesdirect.net

Organizations & group practices 2

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": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1386017994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ARCHANABEN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016876400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.