Individual provider Active NPI

Sajani Paresh Patel, NP-C

  • Nurse Practitioner
  • Norcross, GA
National Provider Identifier
1609314376
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN220515 Issued in GA
Practice address
4775 Jimmy Carter Blvd Ste 201
Norcross, GA 30093-3760
Phone
(470) 275-4911
NPI assigned
Feb 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X F01170949 GA
Nurse Practitioner 363L00000X RN220515 GA Primary

Addresses

Primary practice location

4775 Jimmy Carter Blvd Ste 201
Norcross, GA 30093-3760

Mailing address

4775 Jimmy Carter Blvd Ste 201
Norcross, GA 30093-3760
Phone (470) 275-4911

Other identifiers 1

IdentifierTypeStateIssuer
F01170949OtherGAAMERICAN ACADEMY OF NURSE PRACTITIONERS

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
I20210927003000 GA Practitioner - Nurse Practitioner 9436556867 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F01170949GAMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Elina Healthcare Inc CurrentSince Oct 1, 2021 Accepting new patients

Locations

4775 Jimmy Carter Blvd
Ste 201
Norcross, GA 30093
Phone (470) 275-4911

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1609314376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD STE 201",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "470-275-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD STE 201",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "470-275-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAJANI",
        "middle_name": "PARESH",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "GA",
            "license": "F01170949",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN220515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F01170949",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.