Individual provider Active NPI

Sejal Patel

  • Physician Assistant
  • Winter Haven, FL
National Provider Identifier
1629739404
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118140 Issued in FL
Practice address
550 Pope Ave NW Ste 200
Winter Haven, FL 33881-4679
Phone
(863) 299-2630
Fax
(863) 904-0398
NPI assigned
Jan 4, 2022
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9118140 FL Primary

Addresses

Primary practice location

550 Pope Ave NW Ste 200
Winter Haven, FL 33881-4679

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (321) 332-6947

Other practice location 1

3240 S Florida Ave Ste 101
Lakeland, FL 33803-4574
Phone (863) 644-7337

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206004342 FL Practitioner - Physician Assistant 8628427358 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovacare Florida Urgent Care, LLCGroup PAC ID 1557802840, 20 clinicians
Partners in Medicine and Surgery, P.a.Group PAC ID 9739352923, 5 clinicians

Practice addresses (Care Compare)

1037 S State Rd
7 Suite 113
Wellington, FL 33414-6139
Phone (561) 798-3030

2441 Oak Myrtle LN
Suite 101
Wesley Chapel, FL 33544-6334
Phone (813) 406-4835

550 Pope Ave NW
Suite 200
Winter Haven, FL 33881-4679
Phone (863) 299-2630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9118140FLMDPhysician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sejal.patel.1@27472.direct.athenahealth.com

Organizations & group practices 3

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1629739404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "321-332-6947",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE NW STE 200",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814679",
            "telephone_number": "863-299-2630",
            "fax_number": "863-904-0398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3240 S Florida Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338034574",
            "country_code": "US",
            "telephone_number": "863-644-7337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SEJAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.