Individual provider Active NPI

Kamal G Patel, PA-C

  • Surgical Physician Assistant
  • Livonia, MI
National Provider Identifier
1487676961
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601003654 Issued in MI
Practice address
36475 5 Mile Rd
Medical Staff Office
Livonia, MI 48154-1971
Phone
(734) 655-1420
Fax
(734) 655-1445
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601003654 MI Primary

Addresses

Primary practice location

36475 5 Mile Rd
Medical Staff Office
Livonia, MI 48154-1971

Mailing address

36475 5 Mile Rd
Medical Staff Office
Livonia, MI 48154-1971
Phone (734) 655-1420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050622000968 MI Practitioner - Physician Assistant 0143265959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-2671

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003654MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Hospital Professional CurrentSince May 1, 2008 Accepting new patients
St Mary Mercy Hospital Crna Current Accepting new patients
St Mary Mercy Hospital Current Accepting new patients

Locations

36475 5 Mile Rd
Ofc
Livonia, MI 48154
Phone (734) 655-1200

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

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.

Hospital & facility affiliations 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487676961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36475 5 MILE RD",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-655-1420",
            "fax_number": "734-655-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36475 5 MILE RD",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-655-1420",
            "fax_number": "734-655-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAMAL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601003654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.