Active NPI
Bhadresh I Patel, M.D.
- Family Medicine Physician
- Port Orange, FL
National Provider Identifier
1467469700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME0068922
- Practice address
- 802 Dunlawton Ave
Ste 101
Port Orange, FL 32127 - Phone
- (386) 788-9086
- Fax
- (386) 788-6589
- NPI assigned
- Aug 1, 2006
- Last updated
- Jun 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME0068922 | FL | Primary |
Addresses
Primary practice location
802 Dunlawton Ave
Ste 101
Port Orange, FL 32127
Mailing address
802 Dunlawton Ave
Suite 101
Port Orange, FL 32127
Phone (386) 788-9086
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 379467900 | Medicaid | FL | |
| 5031818-012 | Other | FL | CIGNA |
| 01-00873 | Other | FL | UHC |
| 27612 | Other | FL | BLUE CROSS BLUE SHIELD |
| 5363010 | Other | FL | AETNA |
| 080137788 | Other | FL | RAILROAD MEDICARE |
| 6009354 | Other | FL | GHI |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
802 Dunlawton Ave
Suite 101
Port Orange, FL 32127-4250
Phone (386) 788-9086
802 Dunlawton Ave
Suite 101
PT Orange, FL 32127-4931
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0068922 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radharaj, Inc | Family Medicine | Current | Accepting new patients |
Locations
802 Dunlawton Ave
Ste 101
Pt Orange, FL 32127
Phone (386) 788-9086
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Halifax Medical Center
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1811991227
-
dba AdventHealth Daytona Beach
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1063426823
-
dba AdventHealth Daytona Beach
- Clinical Medical Laboratory
- Daytona Beach, FL
- NPI 1104696178
Hospital
-
dba AdventHealth New Smyrna Beach
- General Acute Care Hospital
- New Smyrna Beach, FL
- NPI 1871977942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1467469700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 DUNLAWTON AVE",
"address_2": "SUITE 101",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "32127",
"telephone_number": "386-788-9086",
"fax_number": "386-788-6589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 DUNLAWTON AVE",
"address_2": "STE 101",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "32127",
"telephone_number": "386-788-9086",
"fax_number": "386-788-6589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "BHADRESH",
"middle_name": "I",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME0068922",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "379467900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5031818-012",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "01-00873",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "27612",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5363010",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080137788",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "6009354",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.