Individual provider Active NPI

Kruti Patel, DO

  • Family Medicine Physician
  • Maywood, IL
National Provider Identifier
1679152268
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125078254 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(224) 422-0205
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 125078254 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (224) 422-0205

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903001007 PA Practitioner - Family Practice 8820480924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pentahealth, LLCGroup PAC ID 9537586672, 67 clinicians

Practice addresses (Care Compare)

142 Wallace Ave
201 Gateway Medical Associate PC
Downingtown, PA 19335-2643
Phone (610) 873-2700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pentahealth, LLC Family Medicine CurrentSince Oct 1, 2025 Accepting new patients

Locations

142 Wallace Ave
Ste 201
Downingtown, PA 19335
Phone (610) 269-7656

412 Creamery Way
Ste 400
Exton, PA 19341
Phone (610) 269-9448

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1679152268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "224-422-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "224-422-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KRUTI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125078254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.