Individual provider Active NPI

Shital Patel, MD

  • Family Medicine Physician
  • Cary, NC
National Provider Identifier
1639529209
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-01390 Issued in NC
Practice address
3701 NW Cary Pkwy
Cary, NC 27513-8431
Phone
(919) 235-6415
Fax
(919) 235-6416
NPI assigned
Jun 15, 2016
Last updated
Feb 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA10634000 NJ
Family Medicine Physician 207Q00000X 2021-01390 NC Primary

Addresses

Primary practice location

3701 NW Cary Pkwy
Cary, NC 27513-8431

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210708000190 NC Practitioner - Family Practice 6406184423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

3701 NW Cary Pkwy
Cary, NC 27513-8431
Phone (919) 235-6415

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10634000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Phisicians, LLC Family Medicine CurrentSince Jul 19, 2021 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Jul 19, 2021 Accepting new patients
Wake Specialty Physicians, LLC Family Medicine Current Accepting new patients

Locations

110 Kildaire Park Dr
Cary, NC 27518
Phone (919) 235-0616

3701 NW Cary Pkwy
Cary, NC 27513
Phone (919) 235-6415

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

150 E Davie St
Raleigh, NC 27601
Phone (919) 834-5299

11640 Northpark Dr
Wake Forest, NC 27587
Phone (919) 234-4468

Interoperability endpoints

  • Direct secure messaging: spatel359733@directhisp.wakemed.org

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.

Hospital & facility affiliations 3

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1639529209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 NW CARY PKWY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138431",
            "telephone_number": "919-235-6415",
            "fax_number": "919-235-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHITAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10634000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-01390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.