Active NPI
Rajesh Kacharalal Patel, M.D.
- Allergy Physician
- Lake Mary, FL
National Provider Identifier
1619926193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- ME0062618
- Practice address
- 1301 S International Parkway
Suite 1011
Lake Mary, FL 32746-1410 - Phone
- (407) 804-6002
- Fax
- (407) 804-8777
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | ME0062618 | FL | |
| Allergy Physician | 207KA0200X | ME0062618 | FL | Primary |
| Allergy & Immunology (Internal Medicine) Physician | 207RA0201X | ME0062618 | FL | |
| Pediatric Allergy/Immunology Physician | 2080P0201X | ME0062618 | FL |
Addresses
Primary practice location
1301 S International Parkway
Suite 1011
Lake Mary, FL 32746-1410
Mailing address
1772 Holland CT
Longwood, FL 32779-3145
Phone (407) 804-6002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 378852100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1301 S International Pkwy
Suite 1011
Lake Mary, FL 32746-1410
Phone (407) 804-6002
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0062618 | FL | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Asthma Allergy Care Center PL | Allergy & Immunology | Current | Accepting new patients |
| Rene Ab Capulong Mdpa | Past | Accepting new patients |
Locations
1301 S International Pkwy
Ste 1011
Lake Mary, FL 32746
Phone (407) 804-6002
2511 Junior St
Orange City, FL 32763
Phone (386) 736-7600
Organizations & group practices 2
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Orange City, FL
- NPI 1124064456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608595200000",
"number": "1619926193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1772 HOLLAND CT",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327793145",
"telephone_number": "407-804-6002",
"fax_number": "407-804-8777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 S INTERNATIONAL PARKWAY",
"address_2": "SUITE 1011",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327461410",
"telephone_number": "407-804-6002",
"fax_number": "407-804-8777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "RAJESH",
"middle_name": "KACHARALAL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "FL",
"license": "ME0062618",
"primary": false
},
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "FL",
"license": "ME0062618",
"primary": true
},
{
"code": "207RA0201X",
"taxonomy_group": "",
"desc": "Internal Medicine, Allergy & Immunology",
"state": "FL",
"license": "ME0062618",
"primary": false
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "FL",
"license": "ME0062618",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "378852100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.