Jitendra M. Patel, MD
Individual provider Active NPI Psychiatry Physician · Park Hills, MO
NPI 1720065097 · NPPES record last updated Oct 12, 2007
Key facts
- NPI
- 1720065097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 106981 (MO)
- Practice address
- 528 E Main St
Park Hills, MO 63601-2634 - Phone
- (573) 431-3341
- Fax
- (573) 431-5205
- NPI assigned
- Dec 28, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250516000615 | PA | Practitioner - Psychiatry | 7911032651 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106981 | MO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Behavioral Health LLC | Psychiatry | Current |
Accepting new patients |
| Reading Behavioral Healthcare, LLC | Current |
Accepting new patients | |
| Southeast Missouri Community Treatment Center, Inc. | Past | Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
7300 E Indiana St
Ste 103
Evansville, IN 47715
Phone (812) 401-8008
10801 N Michigan Rd
Ste 240
Zionsville, IN 46077
Phone (317) 558-0630
201 Wellness Way
Reading, PA 19605
Phone (484) 339-6037
6100 Tower Cir
Ste 1000
Franklin, TN 37067
Phone (615) 454-7459
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 106981 | MO | Yes |
Addresses
Primary practice location
528 E Main St
Park Hills, MO 63601-2634
Mailing address
PO Box 506
Park Hills, MO 63601-0506
Phone (573) 431-0554
Other providers in Park Hills, MO
- Rochelle F Navis-Andrews
- Samantha Maria Neeley
- Michael J Nelson
- New Hope Residential Care, Inc
- Holly Lynn Noble
- Peachs, Inc
- Premier Muscle and Joint LLC
- Patricia A Presley
- Angelita Pritchett
- Anna Nicole Propst
All providers in Park Hills, MO · Psychiatry Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.