Individual provider Active NPI

Jitendra D Patel, M.D.

  • Internal Medicine Physician
  • Schaumburg, IL
National Provider Identifier
1508915539
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036048034 Issued in IL
Practice address
800 E Woodfield Road
Suite102
Schaumburg, IL 60173
Phone
(847) 884-8160
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036048034 IL Primary

Addresses

Primary practice location

800 E Woodfield Road
Suite102
Schaumburg, IL 60173

Mailing address

290 Lexington CT
Schaumburg, IL 60173-2084
Phone (847) 884-8160

Other identifiers 1

IdentifierTypeStateIssuer
036048034MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20070508000348 IL Practitioner - Internal Medicine 2264538222 Reassigns benefits to 2 organizations
Practice locations: Schaumburg, IL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036048034ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Medical & Wellness Center, LLC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Northwest Primary Care PC Internal Medicine CurrentSince Jun 12, 2017 Accepting new patients
Rajesh P. Shah, M.D.., SC Internal Medicine Past Accepting new patients

Locations

2214 Huntington Dr N
Algonquin, IL 60102
Phone (224) 348-7981

806 E Woodfield Rd
Schaumburg, IL 60173
Phone (847) 278-1243

800 E Woodfield Rd
Ste 102
Schaumburg, IL 60173
Phone (312) 248-7695

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1508915539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 LEXINGTON CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601732084",
            "telephone_number": "847-884-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E WOODFIELD ROAD",
            "address_2": "SUITE102",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "60173",
            "telephone_number": "847-884-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JITENDRA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036048034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048034",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.