Individual provider Active NPI

Rajnikant B Patel, M.D.

  • Child & Adolescent Psychiatry Physician
  • Panama City, FL
National Provider Identifier
1417957242
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME0060091 Issued in FL
Practice address
11 W 23Rd St
Panama City, FL 32405-7603
Phone
(850) 747-0168
Fax
(850) 785-5660
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X ME0060091 FL Primary

Addresses

Primary practice location

11 W 23Rd St
Panama City, FL 32405-7603

Mailing address

4836 Highway 389
Lynn Haven, FL 32444-3336
Phone (850) 747-0168

Other identifiers 2

IdentifierTypeStateIssuer
ME60091OtherFLLICENSE
12679OtherFLBCBSF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2020 through Jan 1, 2028

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417957242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4836 HIGHWAY 389",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443336",
            "telephone_number": "850-747-0168",
            "fax_number": "850-785-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057603",
            "telephone_number": "850-747-0168",
            "fax_number": "850-785-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RAJNIKANT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME0060091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME60091",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSF",
            "identifier": "12679",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.