Individual provider Active NPI

Mukti Patel

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1578207353
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
67451 Issued in CA
Practice address
200 2ND Ave S
St Petersburg, FL 33701-4313
Phone
(347) 830-7720
NPI assigned
Apr 26, 2022
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
TPPA710OtherFLDOH FL
11044OtherGAGCMB

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215002235 GA Practitioner - Physician Assistant 4789053653 Reassigns benefits to 4 organizations

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
American Current Care PAGroup PAC ID 9739260019, 545 clinicians
Thriving LaneGroup PAC ID 1355741083, 24 clinicians
Interstate Health Systems IncGroup PAC ID 0749634939, 4 clinicians

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

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Sep 6, 2022 Accepting new patients
American Current Care P.a. CurrentSince Jul 26, 2024 Accepting new patients
Interstate Health Systems, Inc CurrentSince Mar 22, 2025 Accepting new patients
American Current Care PA CurrentSince Jul 26, 2024 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Oct 28, 2024 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.

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

Verify at the official NPI Registry.