Individual provider Active NPI

Dhaval Bhupendra Patel, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Jacksonville, FL
National Provider Identifier
1407048317
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
ME 108209 Issued in FL
Practice address
800 Prudential Dr
Jacksonville, FL 32207-8202
Phone
(904) 202-8000
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME 108209 FL Primary

Addresses

Primary practice location

800 Prudential Dr
Jacksonville, FL 32207-8202

Mailing address

10901 Burnt Mill Rd Apt 1005
Jacksonville, FL 32256-2856
Phone (561) 308-6901

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821002758 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 0345468096 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 108209FLMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Mar 1, 2024 Accepting new patients
Paragon Emergency Services LLC Pediatric Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Phoenix Emergency Medicine of Broward LLC Current Accepting new patients
Paragon Contracting Services LLC Pediatric Emergency Medicine CurrentSince Nov 7, 2024 Accepting new patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Mar 1, 2024 Accepting new patients
Emergency Pediatric Services, PA Past Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 7

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1407048317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 BURNT MILL RD APT 1005",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562856",
            "telephone_number": "561-308-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-202-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHAVAL",
        "middle_name": "BHUPENDRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME 108209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.