NPIMap

Individual provider Active NPI

Suryachandra S Patel, M.D.

  • Family Medicine Physician
  • Irvington, KY
National Provider Identifier
1447393483
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20984 Issued in KY
Practice address
205 West US 60
Irvington, KY 40146
Phone
(270) 547-7161
Fax
(270) 547-7163
NPI assigned
Feb 15, 2007
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20984 KY Primary

Addresses

Primary practice location

205 West US 60
Irvington, KY 40146

Mailing address

PO Box 147
Irvington, KY 40146-0147
Phone (270) 547-7161

Other identifiers 5

IdentifierTypeStateIssuer
000000047259OtherKYANTHEM BCBS
2432480000OtherKYPASSPORT ADVANTAGE
64209844MedicaidKY
P00010531OtherKYRAILROAD MEDICARE
1049345OtherKYPASSPORT HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101005000913 KY Practitioner - Family Practice 3678765989 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Irvington, KY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patel Medical Center PLLCGroup PAC ID 8123340064, 4 clinicians

Practice addresses (Care Compare)

205 W Hwy 60
Irvington, KY 40146-6284
Phone (270) 547-7161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20984KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surychandra S Patel Family Medicine CurrentSince Jan 2, 2000 Accepting new patients
Patel Medical Center PLLC CurrentSince Jan 1, 2014 Accepting new patients
Patel Medical Center PLLC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Brandenburg Opco LLC Past Accepting new patients

Locations

205 W Highway 60
Irvington, KY 40146
Phone (270) 547-7161

Interoperability endpoints

  • Direct secure messaging: sspatel@patelmedical.qrsdm.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Patel Medical CenterIrvington, KY, CCN B08901 Rural health clinic Corporate Officer Aug 1, 2024
Patel Medical Center & Urgent CareHardinsburg, KY, CCN B03971 Rural health clinic Corporate Officer Aug 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1447393483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "IRVINGTON",
            "state": "KY",
            "postal_code": "401460147",
            "telephone_number": "270-547-7161",
            "fax_number": "270-547-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WEST US 60",
            "city": "IRVINGTON",
            "state": "KY",
            "postal_code": "40146",
            "telephone_number": "270-547-7161",
            "fax_number": "270-547-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SURYACHANDRA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "20984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000047259",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432480000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64209844",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00010531",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "1049345",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, KY

Sources for this page

Verify at the official NPI Registry.