Individual provider Active NPI

Kush Shashikant Patel, MD

  • Urology Physician
  • Statesville, NC
National Provider Identifier
1497912018
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2013-01740 Issued in NC
Practice address
208 Old Mocksville Rd
Statesville, NC 28625-1953
Phone
(704) 871-9818
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2013-01740 NC Primary

Addresses

Primary practice location

208 Old Mocksville Rd
Statesville, NC 28625-1953

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 871-9818

Other identifiers 1

IdentifierTypeStateIssuer
1497912018MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140225001503 NC Practitioner - Urology 8628205341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Ohio Medical University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Stone Center PLLCGroup PAC ID 2961315718, 71 clinicians
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

1907 S Hawthorne Rd
Winston Salem, NC 27103-3916
Phone (336) 765-6373

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (336) 765-6373

702 Hartness Rd
Statesville, NC 28677-3425
Phone (704) 871-9818

Hospital & facility affiliations

  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039
  • Duke Health Lake Norman Hospital Hospital, Mooresville, NC, CCN 340129
  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-01740NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Feb 1, 2014 Accepting new patients
Piedmont Stone Center PLLC Urology CurrentSince Mar 24, 2014 Accepting new patients
Piedmont Healthcare, P.a. Urology CurrentSince Feb 1, 2014 Accepting new patients

Locations

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

702 Hartness Rd
Statesville, NC 28677
Phone (704) 871-9818

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

218 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-7461

1907 S Hawthorne Rd
Winston Salem, NC 27103

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: kushpatel@phc.allscriptsdirect.net

Organizations & group practices 3

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 3

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1497912018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-871-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251953",
            "telephone_number": "704-871-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KUSH",
        "middle_name": "SHASHIKANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2013-01740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497912018",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.