Individual provider Active NPI

Dhaval D Patel, DPM

  • Podiatrist
  • Franklin Park, NJ
National Provider Identifier
1629620471
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1-0010272 Issued in DE
Practice address
56 Fisher Dr
Franklin Park, NJ 08823-1347
Phone
(732) 789-6040
NPI assigned
Jul 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1-0010272 DE Primary
Foot & Ankle Surgery Podiatrist 213ES0103X E1-0010272 DE
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

56 Fisher Dr
Franklin Park, NJ 08823-1347

Mailing address

56 Fisher Dr
Franklin Park, NJ 08823-1347
Phone (732) 789-6040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210820001604 NJ Practitioner - Podiatry 6709281264 Reassigns benefits to 1 organization
Practice locations: Lyndhurst, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SMGH Physician Practice Management, LLC CurrentSince Jun 9, 2021 Accepting new patients

Locations

1033 Clifton Ave
Clifton, NJ 07013
Phone (973) 473-5700

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1629620471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 FISHER DR",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231347",
            "telephone_number": "732-789-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FISHER DR",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231347",
            "telephone_number": "732-789-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHAVAL",
        "middle_name": "D",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "DE",
            "license": "E1-0010272",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "DE",
            "license": "E1-0010272",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Park, NJ

Sources for this page

Verify at the official NPI Registry.