Active NPI
Ketan A. Patel, MD
- Cytopathology Physician
- Johnson City, NY
National Provider Identifier
1700850385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cytopathology Physician
- License
- 233912-1
- Practice address
- 33-57 Harrison St
Johnson City, NY 13790-2107 - Phone
- (607) 763-6151
- Fax
- (607) 763-5952
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | 233912-1 | NY | Primary |
Addresses
Primary practice location
33-57 Harrison St
Johnson City, NY 13790-2107
Mailing address
346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 729-8156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02604566 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 233912-1 | NY | MD | Cytopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321660800000",
"number": "1700850385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "346 GRAND AVE",
"city": "JOHNSON CITY",
"state": "NY",
"postal_code": "137902580",
"telephone_number": "607-729-8156",
"fax_number": "607-729-2209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33-57 HARRISON ST",
"city": "JOHNSON CITY",
"state": "NY",
"postal_code": "137902107",
"telephone_number": "607-763-6151",
"fax_number": "607-763-5952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KETAN",
"middle_name": "A.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2011-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "NY",
"license": "233912-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02604566",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.