Individual provider Active NPI

Mitesh Jagdish Patel, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1639501596
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08635 Issued in TX
Practice address
200 W Magnolia Ave Ste 201
Fort Worth, TX 76104-7657
Phone
(817) 702-2977
NPI assigned
Aug 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 PA08635 TX Primary

Addresses

Primary practice location

200 W Magnolia Ave Ste 201
Fort Worth, TX 76104-7657

Mailing address

PO Box 732973 Suite 605
Dallas, TX 75373-1615

Other practice location 1

3900 Junius St
Suite 605
Dallas, TX 75246-1615
Phone (214) 820-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140305001986 TX Practitioner - Physician Assistant 8628208972 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Nov 23, 2013 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 23, 2013 Accepting new patients
Medhealth CurrentSince Jan 1, 2023 Accepting new patients
Texas Heart Hospital of the Southwest LLC CurrentSince Jan 15, 2018 Accepting new patients
Texas Heart Hospital of the Southwest LLP Physician Assistant CurrentSince Jan 15, 2018 Accepting new patients
Medhealth Current Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3900 Junius St
Ste 605
Dallas, TX 75246
Phone (214) 814-1711

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

1100 Allied Dr
Plano, TX 75093
Phone (469) 814-3278

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: mpatel225796@direct.sw.org

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1639501596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732973 SUITE 605",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-2977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Junius St",
            "address_2": "Suite 605",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752461615",
            "country_code": "US",
            "telephone_number": "214-820-7100",
            "fax_number": "214-820-6863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MITESH",
        "middle_name": "JAGDISH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.