Individual provider Active NPI

Pankaj Harji Patel, MD, FACS

  • Trauma Surgery Physician
  • Atlantic City, NJ
National Provider Identifier
1407816721
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
25MA06896800 Issued in NJ
Practice address
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone
(609) 441-8023
NPI assigned
Mar 23, 2006
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD-059559-L PA
Surgical Critical Care Physician 2086S0102X MD-059559-L PA
Trauma Surgery Physician 2086S0127X 25MA06896800 NY
Trauma Surgery Physician 2086S0127X 25MA06896800 NJ Primary

Addresses

Primary practice location

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Mailing address

1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563
Phone (215) 955-6760

Other practice location 1

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Other practice location 2

1100 Walnut St
Suite 500
Philadelphia, PA 19107-5563
Phone (215) 955-6750

Other practice location 3

2 Capital Way Ste 356
Pennington, NJ 08534-2521
Phone (609) 537-6000

Other identifiers 17

IdentifierTypeStateIssuer
P00251486OtherPARAILROAD MEDICARE
001871486MedicaidPA
1758618OtherPAHIGHMARK BLUE SHIELD
392055OtherPAMAMSI-WMG
647030OtherMDCAREFIRST MD BCBS
7391171OtherPAAETNA
8531901MedicaidNJ
02316296MedicaidNY
20045808OtherPAAMERIHEALTH MERCY-WMG
0001021401MedicaidDE
63568OtherPAGEISINGER
683403500MedicaidMD
50053498OtherPACAPITAL BLUE CROSS-WMG
170856OtherPAUNISON-WMG
Q06003MedicaidSC
1547026OtherPAGATEWAY-WMG
2423575000OtherPAAMERIHEALTH 65 PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050914001171 PA Practitioner - General Surgery 1355374992 Reassigns benefits to 2 organizations
I20190610001469 NJ Practitioner - General Surgery 1355374992 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8146

5401 Old York Rd
Philadelphia, PA 19141-3030
Phone (215) 457-4444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-059559-LPAMDSurgery Physician
25MA06896800NYMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group, PA CurrentSince Aug 11, 2024 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Capital Health Multispecialty Group Surgery CurrentSince Jun 1, 2019 Accepting new patients
Atlanticare Physician Group PA Surgery CurrentSince Aug 11, 2024 Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Atlanticare Regional Medical Center CurrentSince Jul 5, 2024 Accepting new patients
Capital Health Medical Group Surgery CurrentSince Dec 1, 2019 Accepting new patients
Einstein Practice Plan Inc CurrentSince Aug 17, 2019 Accepting new patients
Atlanticare Regional Medical Center Surgery CurrentSince Jul 5, 2024 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc Surgery CurrentSince Aug 17, 2019 Accepting new patients
Jefferson University Physicians PastSince Sep 1, 2007 Accepting new patients
Albert Einstein Medical Center Past Accepting new patients
Christiana Care Health Services, Inc Surgery Past Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

2 Capital Way
Ste 356
Pennington, NJ 08534
Phone (609) 537-6000

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5401 Old York Rd
Ste 101
Philadelphia, PA 19141
Phone (215) 456-6178

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

9880 Bustleton Ave
Ste 205
Philadelphia, PA 19115
Phone (215) 676-2222

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1407816721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WALNUT ST",
            "address_2": "SUITE 500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075563",
            "telephone_number": "215-955-6760",
            "fax_number": "215-923-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "NJ",
            "postal_code": "086384143",
            "country_code": "US",
            "telephone_number": "609-394-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Walnut St",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075563",
            "country_code": "US",
            "telephone_number": "215-955-6750",
            "fax_number": "215-923-8222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Capital Way Ste 356",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "085342521",
            "country_code": "US",
            "telephone_number": "609-537-6000",
            "fax_number": "609-537-6002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PANKAJ",
        "middle_name": "HARJI",
        "name_prefix": "Dr.",
        "credential": "MD, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD-059559-L",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD-059559-L",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NY",
            "license": "25MA06896800",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NJ",
            "license": "25MA06896800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00251486",
            "state": "PA"
        },
        {
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            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001871486",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1758618",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-WMG",
            "identifier": "392055",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "647030",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7391171",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8531901",
            "state": "NJ"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "02316296",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "20045808",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001021401",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "63568",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "683403500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "50053498",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "170856",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q06003",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1547026",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65 PA",
            "identifier": "2423575000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.