Palakkumar B Patel, PA -C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

012943 Issued in NY

Practice address

60 N Country Rd Ste 203
Port Jefferson, NY 11777-2188

Phone

(631) 928-3444

NPI assigned

Nov 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1225497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225497600000",
    "number": "1699928846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 GRUNDY AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117412633",
            "telephone_number": "631-219-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N COUNTRY RD STE 203",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772188",
            "telephone_number": "631-928-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PALAKKUMAR",
        "middle_name": "B",
        "credential": "PA -C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-01",
        "last_updated": "2008-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard T. Pastula II, D.O.
• Gina Patalano
• Dhruv Patel, MD
• Neel Patel, MD
• Nick N Patel, D.O.
• Raj Patel
• Saurabh Patel, M.D.
• Irene Diana Patrylo, M.D.
• Marlene Carolina Patti, LMSW
• Paul a. Lusman, M.D.P.C.

• Physician Assistant in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.