Individual provider Active NPI

Dev Patel, PA-C

  • Physician Assistant
  • Hazle Township, PA
National Provider Identifier
1396457180
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063848 Issued in PA
Practice address
50 Moisey Dr Ste 212
Hazle Township, PA 18202-9297
Phone
(570) 501-7020
NPI assigned
Dec 23, 2022
Last updated
Apr 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X MA063848 PA Primary

Addresses

Primary practice location

50 Moisey Dr Ste 212
Hazle Township, PA 18202-9297

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (570) 501-6369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230307000842 PA Practitioner - Physician Assistant 2961875299 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063848PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Mar 1, 2023 Accepting new patients
Family Care Centers Inc CurrentSince May 1, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 1, 2023 Accepting new patients
Hazleton Professional Services CurrentSince Mar 1, 2023 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

50 Moisey Dr
Ste 212
Hazle Township, PA 18202
Phone (570) 459-5030

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1396457180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "570-501-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOISEY DR STE 212",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182029297",
            "telephone_number": "570-501-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DEV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-23",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.