Individual provider Active NPI

Prachiben Patel

  • Family Nurse Practitioner
  • Scranton, PA
National Provider Identifier
1629682729
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022416 Issued in PA
Practice address
1405 Mulberry St
Scranton, PA 18510-2200
Phone
(570) 342-8199
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP022416 PA Primary

Addresses

Primary practice location

1405 Mulberry St
Scranton, PA 18510-2200

Mailing address

1405 Mulberry St
Scranton, PA 18510-2200
Phone (570) 342-8199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201125001343 PA Practitioner - Nurse Practitioner 0941611842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP022416PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC CurrentSince Nov 1, 2020 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

393 Broadway
Brooklyn, NY 11211
Phone (516) 984-9692

498 Washington St
Easton, PA 18042
Phone (610) 253-4821

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1629682729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 MULBERRY ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102200",
            "telephone_number": "570-342-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MULBERRY ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102200",
            "telephone_number": "570-342-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRACHIBEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.