Individual provider Active NPI

Ajaykumar Patel

  • Physical Therapist
  • Richmond, TX
National Provider Identifier
1417359043
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1370987 Issued in TX
Practice address
18502 W Bellfort St Ste 118
Richmond, TX 77407-9003
Phone
(248) 403-1730
NPI assigned
Sep 26, 2014
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501016850 MI
Physical Therapist 225100000X 1370987 TX Primary

Addresses

Primary practice location

18502 W Bellfort St Ste 118
Richmond, TX 77407-9003

Mailing address

18502 W Bellfort St Ste 118
Richmond, TX 77407-9003
Phone (248) 403-1730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230201003192 TX Practitioner - Physical Therapist in Private Practice 8325321722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Therapy, PCGroup PAC ID 6507831773, 14 clinicians

Practice addresses (Care Compare)

18502 W Bellfort St
Suite 118
Richmond, TX 77407-9003
Phone (979) 774-9958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501016850MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Therapy PC Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Brain and Spine Rehab Services LLC Physical Therapist Current Accepting new patients
Advance Therapy PC Physical Therapist Past Accepting new patients

Locations

3700 Cross Park Dr
Bryan, TX 77802
Phone (979) 774-9958

15119 Wallisville Rd
Ste 100
Houston, TX 77049
Phone (832) 626-3366

9638 Huffmeister Rd
#A
Houston, TX 77095
Phone (281) 214-2121

18502 W Bellfort St
Ste 118
Richmond, TX 77407
Phone (248) 403-1730

Organizations & group practices 3

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1417359043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18502 W BELLFORT ST STE 118",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774079003",
            "telephone_number": "248-403-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18502 W BELLFORT ST STE 118",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774079003",
            "telephone_number": "248-403-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AJAYKUMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-26",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016850",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1370987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.