Individual provider Active NPI

Bhavesh A Patel, M.D.

  • Psychiatry Physician
  • Valdosta, GA
National Provider Identifier
1417985730
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
056163 Issued in GA
Practice address
2704 N Oak St
Building B-3
Valdosta, GA 31602-1744
Phone
(229) 257-0100
Fax
(229) 257-0050
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 056163 GA Primary

Addresses

Primary practice location

2704 N Oak St
Building B-3
Valdosta, GA 31602-1744

Mailing address

2704 N Oak St
Building B-3
Valdosta, GA 31602-1744
Phone (229) 257-0100

Other practice location 1

3312 N Oak St Ext Bldg D
Valdosta, GA 31605-1066
Phone (229) 244-2030

Other identifiers 1

IdentifierTypeStateIssuer
118324078AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050805000260 GA Practitioner - Psychiatry 6002845567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ar Psychiatric and Counseling Center LLCGroup PAC ID 9335326941, 11 clinicians

Practice addresses (Care Compare)

3312 N Oak St Ext
BLDG D
Valdosta, GA 31605-1066
Phone (229) 244-2030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
056163GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ar Psychiatric & Counseling Center LLC Psychiatry CurrentSince Oct 14, 2020 Accepting new patients
SGMP Southland LLC Psychiatry CurrentSince Jan 2, 2018 Accepting new patients
Choice Family Medicine, PC Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia Past Accepting new patients

Locations

2014 Pineview Ave
Tifton, GA 31794
Phone (229) 387-8878

201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041

2217 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

2209 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

3312 N Oak Street Ext
Bldg D
Valdosta, GA 31605
Phone (229) 244-2030

Organizations & group practices 4

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1417985730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST",
            "address_2": "BUILDING B-3",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021744",
            "telephone_number": "229-257-0100",
            "fax_number": "229-257-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST",
            "address_2": "BUILDING B-3",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021744",
            "telephone_number": "229-257-0100",
            "fax_number": "229-257-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3312 N Oak St Ext Bldg D",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316051066",
            "country_code": "US",
            "telephone_number": "229-244-2030",
            "fax_number": "229-244-2038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BHAVESH",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "056163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118324078A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.