Minati Pattanayak, M.D, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA41600 Issued in NJ

Practice address

89 Somerset Drive
Willingboro, NJ 08046

Phone

(609) 877-4545

Fax

(609) 877-5129

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lourdes Medical Associates PA

  • Family Medicine Physician
  • Haddon Heights, NJ
  • NPI 1568441541
  NPD (past)
• Lourdes Medical Associates, PA

  dba Lourdes Medical Associates Surigcal Specialists

  • Surgery Physician
  • Moorestown, NJ
  • NPI 1952645525
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700971215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 SOMERSET DRIVE",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "08046",
            "telephone_number": "609-877-4545",
            "fax_number": "609-877-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SOMERSET DRIVE",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "08046",
            "telephone_number": "609-877-4545",
            "fax_number": "609-877-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTANAYAK",
        "first_name": "MINATI",
        "name_prefix": "Dr.",
        "credential": "M.D, PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA41600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3358909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hiren M Patel, R.PH
• Julie Patel, FNP-C
• Neel Patel
• Nidhiben Sanjaykumar Patel, MD
• Riya N Patel, OD
• Benoy Paul, M.D.
• Karel Joseph Paul, M.D.
• Lucie Paul
• Tracy Logan Persily, D.O.
• Personalized Independent Living Opporuntities & Training Services (P.I.L.O.T. Services)

• Family Medicine Physician in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.