Individual provider Active NPI

Kaushal Patel, DPT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1619634946
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4776 Hodges Blvd Ste 101
Jacksonville, FL 32224-7218
Phone
(904) 223-2363
NPI assigned
Nov 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4776 Hodges Blvd Ste 101
Jacksonville, FL 32224-7218

Mailing address

4870 Deer Lake Dr E Ste 4303
Jacksonville, FL 32246-6321
Phone (912) 220-6850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211129002277 FL Practitioner - Physical Therapist in Private Practice 6406246834 Reassigns benefits to 1 organization
I20240328003615 GA Practitioner - Physical Therapist in Private Practice 6406246834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Care Medical Center LLCGroup PAC ID 6406807015, 28 clinicians

Practice addresses (Care Compare)

2804 N Oak St
Suite C
Valdosta, GA 31602-5913
Phone (229) 241-8925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
In Motion Physical Therapy LLC CurrentSince Nov 22, 2021 Accepting new patients
In Motion Physical Therapy LLC CurrentSince Nov 22, 2021 Accepting new patients
Performance Physio LLC Current Accepting new patients
Care Medical Center LLC CurrentSince Jan 5, 2024 Accepting new patients
Care Medical Center LLC CurrentSince Jan 5, 2024 Accepting new patients

Locations

4776 Hodges Blvd
Ste 101
Jacksonville, FL 32224
Phone (904) 223-2363

306 Shirley Ave
Douglas, GA 31533
Phone (229) 241-8925

2804 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 241-8925

1411 Alice St
Waycross, GA 31501
Phone (912) 282-2989

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1619634946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 DEER LAKE DR E STE 4303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466321",
            "telephone_number": "912-220-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4776 HODGES BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247218",
            "telephone_number": "904-223-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAUSHAL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.