Active NPI
Mukti Patel
- Physician Assistant
- St Petersburg, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 67451
- Practice address
- 200 2ND Ave S
St Petersburg, FL 33701-4313 - Phone
- (347) 830-7720
- NPI assigned
- Apr 26, 2022
- Last updated
- Jul 14, 2026
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 67451 | CA | Primary |
Addresses
Primary practice location
200 2ND Ave S
St Petersburg, FL 33701-4313
Mailing address
1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331
Other practice location 1
2 Embarcadero Ctr
San Francisco, CA 94111-3823
Phone (888) 663-6331
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TPPA710 | Other | FL | DOH FL |
| 11044 | Other | GA | GCMB |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
109 Minus Ave
Suite C10
Garden City, GA 31408-2130
Phone (912) 966-5445
2801 Buford Hwy NE
Suite T10
Atlanta, GA 30329-2149
Phone (347) 830-7720
5712 Hwy 21
Suite 300
Port Wentworth, GA 31407
Phone (800) 756-1591
688 Spring St NW
Atlanta, GA 30308-1934
Phone (404) 881-1155
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group of Georgia LLC | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients | |
| Interstate Health Systems, Inc | Current | Accepting new patients | |
| American Current Care PA | Current | Accepting new patients | |
| St Josephs Candler Urgent Care Centers LLC | Current | Accepting new patients | |
| Margaret Ellis, MD, LLC | Past | Accepting new patients |
Locations
688 Spring St NW
Atlanta, GA 30308
Phone (404) 881-1155
64 Oracal Pkwy
Bldg 1
Ellabell, GA 31308
Phone (912) 214-7920
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
780 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 332-7262
101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945
107 Canal St
Pooler, GA 31322
Phone (912) 450-1945
5712 State Highway 21
Ste 300
Port Wentwrth, GA 31407
Phone (800) 756-1591
13314 Highway 144
Ste C
Richmond Hill, GA 31324
Phone (912) 910-2010
5621 Highway 21 S
Rincon, GA 31326
Phone (912) 295-5860
361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221
1096 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-5150
7200 Strawberry Plains Pike
Knoxville, TN 37914
Phone (225) 363-2166
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Addison, TX
- NPI 1710168117
GA
-
dba Interstate Health
- Family Medicine Physician
- Knoxville, TN
- NPI 1073216990
GA
-
- Internal Medicine Physician
- Fayetteville, GA
- NPI 1013313857
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Beaumont, TX
- NPI 1376356568
-
dba Interstate Health
- Rural Health Clinic/Center
- Knoxville, TN
- NPI 1437961000
-
- Internal Medicine Physician
- Savannah, GA
- NPI 1356907273
-
- Urgent Care Clinic/Center
- Bluffton, SC
- NPI 1902468697
-
dba The Center for Developmental Pediatrics
- Developmental - Behavioral Pediatrics Physician
- Savannah, GA
- NPI 1275022907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1578207353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EMBARCADERO CTR STE 1900",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941113723",
"telephone_number": "888-663-6331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 2ND AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014313",
"telephone_number": "347-830-7720"
}
],
"practiceLocations": [
{
"address_1": "2 Embarcadero Ctr",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941113823",
"country_code": "US",
"telephone_number": "888-663-6331",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "MUKTI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-26",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "67451",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOH FL",
"identifier": "TPPA710",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GCMB",
"identifier": "11044",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.