Individual provider Active NPI

Ketan B Patel, DPM

  • Foot & Ankle Surgery Podiatrist
  • Conyers, GA
National Provider Identifier
1447254131
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000928 Issued in GA
Practice address
1720 Honey Creek Commons
Ste B
Conyers, GA 30013-5826
Phone
(770) 483-1100
Fax
(770) 483-5855
NPI assigned
Jun 9, 2005
Last updated
Dec 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000928 GA Primary

Addresses

Primary practice location

1720 Honey Creek Commons
Ste B
Conyers, GA 30013-5826

Mailing address

1975 Highway 54 W
Suite 205
Peachtree City, GA 30269-4794
Phone (678) 561-9000

Other identifiers 1

IdentifierTypeStateIssuer
00915725AMedicaidGA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101015000793 GA Practitioner - Podiatry 0244387785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Centers of Georgia, LLCGroup PAC ID 8022295294, 52 clinicians

Practice addresses (Care Compare)

1819 Peachtree Rd NE
Suite 225
Atlanta, GA 30309-1848
Phone (404) 351-5015

1975 Hwy 54 W
Peachtree City, GA 30269-4794

2520 Windy Hill Rd SE
Suite 105
Marietta, GA 30067-8633
Phone (770) 952-5300

5335 Old National Hwy
Atlanta, GA 30349-3203
Phone (404) 768-3668

7130 Mount Zion Blvd
Suite 13
Jonesboro, GA 30236-2566
Phone (770) 478-3668

990 Holcomb Bridge Rd
Suite 4
Roswell, GA 30076-6203
Phone (770) 992-9980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.6 of 100Reported as group
Quality
88.21
Promoting interoperability
100
Improvement activities
40
Cost
83.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue54
Removal of skin lesions1-10
Removal of nail tissue370
Removal or shaving of skin growth155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000928GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle and Foot Centers of Georgia, LLC Foot & Ankle Surgery CurrentSince Jul 1, 2011 Accepting new patients
Ankle and Foot Centers of Georgia, LLC Foot & Ankle Surgery CurrentSince Jul 1, 2011 Accepting new patients
Ankle and Foot Center of Georgia,LLC Past Accepting new patients
Institute of Restorative Medicine PastSince Jun 1, 2024 Accepting new patients

Locations

1819 Peachtree Rd NE
Ste 225
Atlanta, GA 30309
Phone (404) 351-5015

550 Peachtree St NE
Ste 1615
Atlanta, GA 30308
Phone (404) 577-8180

3425 Buford Dr
Ste 350
Buford, GA 30519
Phone (470) 589-1617

795 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 629-1852

5335 Old National Hwy
College Park, GA 30349
Phone (404) 768-3668

1720 Honey Creek Cmns SE
Ste B
Conyers, GA 30013
Phone (404) 963-1802

1075 Lafayette Pkwy
Ste 200
Lagrange, GA 30241
Phone (678) 347-2123

748 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (404) 297-4230

2520 Windy Hill Rd SE
Ste 105
Marietta, GA 30067
Phone (770) 952-5300

2520 Windy Hill Rd SE
Ste 205
Marietta, GA 30067
Phone (404) 228-9892

2326 Highway 34 E
Ste 200
Newnan, GA 30265
Phone (678) 561-9000

1975 Highway 54 W
Ste 200
Peachtree Cty, GA 30269
Phone (404) 768-3668

1975 Highway 54 W
Ste 205
Peachtree Cty, GA 30269
Phone (678) 561-9000

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1447254131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 HIGHWAY 54 W",
            "address_2": "SUITE 205",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694794",
            "telephone_number": "678-561-9000",
            "fax_number": "770-487-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 HONEY CREEK COMMONS",
            "address_2": "STE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135826",
            "telephone_number": "770-483-1100",
            "fax_number": "770-483-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KETAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "000928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00915725A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.