Individual provider Active NPI

Anand D Patel, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Brookfield, WI
National Provider Identifier
1518159599
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
61806-20 Issued in WI
Practice address
19275 W Capitol Dr
Suite 205
Brookfield, WI 53045-2742
Phone
(262) 701-7040
Fax
(262) 701-4978
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 61806-20 WI Primary

Addresses

Primary practice location

19275 W Capitol Dr
Suite 205
Brookfield, WI 53045-2742

Mailing address

19275 W Capitol Dr
Suite 205
Brookfield, WI 53045-2742
Phone (262) 701-7040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20140602002555 WI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 4385796010

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Devenir Aesthetics, PA PastSince Jul 3, 2016 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.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1518159599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19275 W CAPITOL DR",
            "address_2": "SUITE 205",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452742",
            "telephone_number": "262-701-7040",
            "fax_number": "262-701-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19275 W CAPITOL DR",
            "address_2": "SUITE 205",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452742",
            "telephone_number": "262-701-7040",
            "fax_number": "262-701-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANAND",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "WI",
            "license": "61806-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.