Individual provider Active NPI

Roshni Patel, MD

  • Interventional Pain Medicine Physician
  • Farmington, CT
National Provider Identifier
1710947106
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
042468 Issued in CT
Practice address
55 South Rd Ste 120
Farmington, CT 06032-2022
Phone
(860) 397-6179
Fax
(860) 321-7148
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 042468 CT
Brain Injury Medicine (Psychiatry & Neurology) Physician 2084P0301X 042468 CT
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 042468 CT
Interventional Pain Medicine Physician 208VP0014X 042468 CT Primary

Addresses

Primary practice location

55 South Rd Ste 120
Farmington, CT 06032-2022

Mailing address

55 South Rd Ste 120
Farmington, CT 06032-2022
Phone (860) 397-6179

Other practice location 1

1001 Farmington Ave
West Hartford, CT 06107
Phone (860) 348-7093

Other identifiers 7

IdentifierTypeStateIssuer
3V1121OtherCTHEALTH NET
422008OtherCTWELLCARE MEDICARE ONLY
3212638OtherCTCIGNA
010042468CT02OtherCTBCBS, BCFP, MEDIBLUE
9932098OtherCTAETNA
001424689MedicaidCT
042468OtherCTCONNECTICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042468CTMDBrain Injury Medicine (Psychiatry & Neurology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1710947106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SOUTH RD STE 120",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322022",
            "telephone_number": "860-397-6179",
            "fax_number": "860-321-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SOUTH RD STE 120",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322022",
            "telephone_number": "860-397-6179",
            "fax_number": "860-321-7148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "06107",
            "country_code": "US",
            "telephone_number": "860-348-7093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHNI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "042468",
            "primary": false
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": "CT",
            "license": "042468",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CT",
            "license": "042468",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CT",
            "license": "042468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3V1121",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE MEDICARE ONLY",
            "identifier": "422008",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3212638",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS, BCFP, MEDIBLUE",
            "identifier": "010042468CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9932098",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001424689",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "042468",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.