Organization Active NPI

Ajay T Patel MD Inc

  • Internal Medicine Physician
  • Saint Albans, WV
National Provider Identifier
1710029715
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20391 Issued in WV
Legal business name
AJAY T PATEL MD INC
Practice address
450 2ND St
Saint Albans, WV 25177-2857
Phone
(304) 727-0016
Fax
(304) 727-2929
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Dr. Ajay PatelNPI 1023078912
Title
Medical Doctor
Phone
(304) 727-0016

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20391 WV Primary

Addresses

Primary practice location

450 2ND St
Saint Albans, WV 25177-2857

Mailing address

450 2ND St
Saint Albans, WV 25177-2857
Phone (304) 727-0016

Other identifiers 1

IdentifierTypeStateIssuer
1804439000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041115001142 WV Part B Supplier - Clinic/Group Practice 9931163466 Receives reassigned benefits from 1 practitioner
Practice locations: St Albans, WV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0983207Ajay T Patel MD450 2ND Street, Saint Albans, WV 25177Provider-performed microscopyFeb 19, 2027

National Provider Directory

National Provider Directory

Locations

450 2nd St
Saint Albans, WV 25177
Phone (304) 727-0016

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1710029715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 2ND ST",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772857",
            "telephone_number": "304-727-0016",
            "fax_number": "304-727-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 2ND ST",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772857",
            "telephone_number": "304-727-0016",
            "fax_number": "304-727-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJAY T PATEL MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "304-727-0016",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "20391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804439000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.