Active NPI
Kaushikkumar Kantilal Patel, RPT
- Physical Therapist
- Macomb, MI
National Provider Identifier
1629382809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501012613
- Practice address
- 49063 Gaviota LN
Macomb, MI 48044-1164 - Phone
- (586) 822-0007
- NPI assigned
- Jul 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501012613 | MI | Primary |
Addresses
Primary practice location
49063 Gaviota LN
Macomb, MI 48044-1164
Mailing address
49063 Gaviota LN
Macomb, MI 48044-1164
Phone (586) 822-0007
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501012613 | Medicaid | MI | |
| 5501012613 | Other | MI | STATE OF MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501012613 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543017600000",
"number": "1629382809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49063 GAVIOTA LN",
"city": "MACOMB",
"state": "MI",
"postal_code": "480441164",
"telephone_number": "586-822-0007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49063 GAVIOTA LN",
"city": "MACOMB",
"state": "MI",
"postal_code": "480441164",
"telephone_number": "586-822-0007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KAUSHIKKUMAR",
"middle_name": "KANTILAL",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-30",
"last_updated": "2018-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501012613",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5501012613",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN",
"identifier": "5501012613",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macomb, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.