Individual provider Active NPI

Payal Patel

  • Medical Physician Assistant
  • Trinity, FL
National Provider Identifier
1457915084
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9119063 Issued in FL
Practice address
2043 Little Rd
Trinity, FL 34655-4421
Phone
(727) 504-9473
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9119063 FL
Medical Physician Assistant 363AM0700X PA9119063 FL Primary

Addresses

Primary practice location

2043 Little Rd
Trinity, FL 34655-4421

Mailing address

19709 Cypress Bridge Dr
Odessa, FL 33556-4439
Phone (347) 531-6426

Other practice location 1

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-2698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241030002785 FL Practitioner - Physician Assistant 0749613362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

18596 Fernview St
Land O Lakes, FL 34638-6232
Phone (770) 312-5226

2043 Little Rd
Trinity, FL 34655-4421
Phone (727) 846-7000

8763 River Crossing Blvd
New Port Richey, FL 34655-1112
Phone (727) 846-7000

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958-4879
Phone (727) 617-1777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9119063FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

8763 River Crossing Blvd
Trinity, FL 34655
Phone (727) 788-4350

2043 Little Rd
Trinity, FL 34655
Phone (727) 375-2222

Interoperability endpoints

  • Direct secure messaging: payal.patel.1@8042.direct.athenahealth.com
  • Direct secure messaging: ppatel1130060@nychhc.direct-ci.com

Organizations & group practices 1

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1457915084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19709 CYPRESS BRIDGE DR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335564439",
            "telephone_number": "347-531-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554421",
            "telephone_number": "727-504-9473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Broadway",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731329",
            "country_code": "US",
            "telephone_number": "718-334-2698",
            "fax_number": "718-334-2117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PAYAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9119063",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9119063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.