Individual provider Active NPI

Jay Sanjay Patel, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Anderson, SC
National Provider Identifier
1689654089
Registry record updated Aug 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
29492 Issued in SC
Practice address
108 Montgomery Dr
Anderson, SC 29621-3334
Phone
(864) 225-5597
Fax
(864) 225-5835
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2081P2900X 29492 SC Primary
Physical Medicine & Rehabilitation Physician 208100000X 29492 SC

Addresses

Primary practice location

108 Montgomery Dr
Anderson, SC 29621-3334

Mailing address

2320 E North St Ste K
Greenville, SC 29607-1250
Phone (850) 339-1359

Other identifiers 3

IdentifierTypeStateIssuer
6089OtherMEDICARE GROUP
AA22586089OtherSCMEDICARE PTAN
294924MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20071025000166 SC Practitioner - Physical Medicine and Rehabilitation 4981629292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29492SCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Pain Management PC Single Specialty CurrentSince Aug 15, 2019 Accepting new patients
The Smart Clinic Physical Medicine & Rehabilitation PastSince Jan 29, 2023 Accepting new patients
Evergreen Medical, Inc. Single Specialty PastSince Mar 12, 2023 Accepting new patients

Locations

108 Montgomery Dr
Anderson, SC 29621
Phone (864) 225-5597

2320 E North St
Ste K
Greenville, SC 29607

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566604800000",
    "number": "1689654089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 E NORTH ST STE K",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296071250",
            "telephone_number": "850-339-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MONTGOMERY DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213334",
            "telephone_number": "864-225-5597",
            "fax_number": "864-225-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAY",
        "middle_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2019-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "SC",
            "license": "29492",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "29492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "6089",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AA22586089",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294924",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.