Individual provider Active NPI

Roshani Patel, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1669093969
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone
(215) 590-1000
NPI assigned
Apr 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Mailing address

17079 Anns Brook CT
Woodbridge, VA 22191-5173
Phone (703) 795-3145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230607001371 PA Practitioner - Physician Assistant 1850758871 Reassigns benefits to 1 organization
I20240611001593 DC Practitioner - Physician Assistant 1850758871 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc CurrentSince Apr 24, 2023 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Apr 24, 2023 Accepting new patients
Children'S Hospital CurrentSince May 29, 2024 Accepting new patients
Children'S Hospital CurrentSince May 29, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Children'S Hospital Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3401 Civic Center Blvd
#M975
Philadelphia, PA 19104

Organizations & group practices 7

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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1669093969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17079 ANNS BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915173",
            "telephone_number": "703-795-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHANI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.