Organization Active NPI

Prabhaker S Patel MD PA

  • Psychiatry Physician
  • Turnersville, NJ
National Provider Identifier
1487720918
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PRABHAKER S PATEL MD PA
Practice address
901 RT 168
Ste 101
Turnersville, NJ 08012
Phone
(856) 228-7577
Fax
(856) 228-0534
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Prabhaker Somabhai Patel, MDNPI 1639242852
Title
President
Phone
(856) 228-0383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

901 RT 168
Ste 101
Turnersville, NJ 08012

Mailing address

901 RT 168
Ste 101
Turnersville, NJ 08012
Phone (856) 228-7577

Other identifiers 1

IdentifierTypeStateIssuer
8644802MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120621000225 NJ Part B Supplier - Clinic/Group Practice 4789848839 Receives reassigned benefits from 2 practitioners
Practice locations: Turnersville, NJ

National Provider Directory

National Provider Directory

Locations

901 Route 168
Ste 101
Turnersville, NJ 08012
Phone (609) 228-7577

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487720918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RT 168",
            "address_2": "STE 101",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-228-7577",
            "fax_number": "856-228-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RT 168",
            "address_2": "STE 101",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-228-7577",
            "fax_number": "856-228-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRABHAKER S PATEL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRABHAKER",
        "authorized_official_middle_name": "SOMABHAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-228-0383",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8644802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.