Active NPI
Priti Dilip Patel, MD
- Geriatric Medicine (Internal Medicine) Physician
- Kenosha, WI
National Provider Identifier
1508813593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 24329
- Practice address
- 6308 8TH Avenue
Ste 2000
Kenosha, WI 53143 - Phone
- (262) 653-5300
- Fax
- (262) 653-5412
- NPI assigned
- May 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 24329 | WI | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 24329 | WI | Primary |
Addresses
Primary practice location
6308 8TH Avenue
Ste 2000
Kenosha, WI 53143
Mailing address
6308 8TH Avenue
Ste 2000
Kenosha, WI 53143
Phone (262) 653-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30436000 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24329 | WI | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenosha Pathology Consultants | Past | Accepting new patients |
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Kenosha, WI
- NPI 1790812857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205452800000",
"number": "1508813593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6308 8TH AVENUE",
"address_2": "STE 2000",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53143",
"telephone_number": "262-653-5300",
"fax_number": "262-653-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6308 8TH AVENUE",
"address_2": "STE 2000",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53143",
"telephone_number": "262-653-5300",
"fax_number": "262-653-5412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "PRITI",
"middle_name": "DILIP",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-27",
"last_updated": "2008-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "24329",
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "WI",
"license": "24329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30436000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.