Organization Active NPI

Girish Patel MD PA

  • Specialist
  • St Petersburg, FL
National Provider Identifier
1619054871
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0068180 Issued in FL
Legal business name
GIRISH PATEL MD PA
Practice address
2112 16TH St N
Saint Petersburg, FL 33704-3924
Phone
(727) 821-7111
Fax
(727) 821-7115
NPI assigned
Nov 1, 2006
Last updated
Feb 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Authorized official

Name
Girish Patel, MD PANPI 1508975343
Title
Physician
Phone
(727) 821-7111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0068180 FL Primary

Addresses

Primary practice location

2112 16TH St N
Saint Petersburg, FL 33704-3924

Mailing address

2112 16TH St N
Saint Petersburg, FL 33704-3924
Phone (727) 821-7111

Other identifiers 1

IdentifierTypeStateIssuer
378469000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061103000363 FL Part B Supplier - Clinic/Group Practice 6406853571 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

2112 16th St N
St Petersburg, FL 33704
Phone (727) 821-2171

2191 9th Ave N
Ste 250
St Petersburg, FL 33713
Phone (727) 321-9566

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1619054871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 16TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337043924",
            "telephone_number": "727-821-7111",
            "fax_number": "727-821-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 16TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337043924",
            "telephone_number": "727-821-7111",
            "fax_number": "727-821-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIRISH PATEL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "GIRISH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-821-7111",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0068180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378469000",
            "state": "FL"
        }
    ],
    "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 Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.