Active NPI
Jayantkumar Chhotabhai Patel, M.D.
- Psychiatry Physician
- Willimantic, CT
National Provider Identifier
1396779658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 020512
- Practice address
- 132 Mansfield Ave
Suite-200
Willimantic, CT 06226-2033 - Phone
- (860) 456-2261
- Fax
- (860) 450-1357
- NPI assigned
- Jul 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 020512 | CT | Primary |
Addresses
Primary practice location
132 Mansfield Ave
Suite-200
Willimantic, CT 06226-2033
Mailing address
132 Mansfield Ave
Suite - 200
Willimantic, CT 06226-2033
Phone (860) 456-2261
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001205129 | Medicaid | CT |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020512 | CT | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1396779658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 MANSFIELD AVE",
"address_2": "SUITE - 200",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062262033",
"telephone_number": "860-456-2261",
"fax_number": "860-450-1357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 MANSFIELD AVE",
"address_2": "SUITE-200",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062262033",
"telephone_number": "860-456-2261",
"fax_number": "860-450-1357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JAYANTKUMAR",
"middle_name": "CHHOTABHAI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "020512",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001205129",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.