Individual provider Active NPI

Sanjiv C Patel, M.D.

  • Family Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1720113962
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA05916000 Issued in NJ
Practice address
147 E 3Rd St
Ste 2
Moorestown, NJ 08057-2924
Phone
(856) 234-2500
Fax
(856) 234-3907
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA05916000 NJ Primary

Addresses

Primary practice location

147 E 3Rd St
Ste 2
Moorestown, NJ 08057-2924

Mailing address

147 E 3Rd St
Ste 2
Moorestown, NJ 08057-2924
Phone (856) 234-2500

Other identifiers 1

IdentifierTypeStateIssuer
7559500MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spatel14368@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080805000422 NJ Practitioner - Internal MedicinePractitioner - Family Practice 1456425743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

147 E 3Rd St
Suite 2
Moorestown, NJ 08057-2924
Phone (856) 234-2500

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Mount Holly Rehabilitation & Healthcare Center Nursing home, Lumberton, NJ, CCN 315128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05916000NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine CurrentSince Feb 1, 2014 Accepting new patients
Virtua Medical Group, PA CurrentSince Feb 1, 2014 Accepting new patients
Mount Holly Operator LLC Past Accepting new patients
Virtua Surgical Group, P.a Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1000 Atlantic Ave
Camden, NJ 08104
Phone (856) 246-3060

62 Richmond Ave
Lumberton, NJ 08048
Phone (609) 267-8800

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

542 Lippincott Dr
Marlton, NJ 08053
Phone (856) 596-3393

147 E 3rd St
Ste 2
Moorestown, NJ 08057
Phone (856) 234-2500

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

Interoperability endpoints

  • Direct secure messaging: spatel14368@directvirtua.org

Organizations & group practices 4

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

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1720113962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 E 3RD ST",
            "address_2": "STE 2",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572924",
            "telephone_number": "856-234-2500",
            "fax_number": "856-234-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 E 3RD ST",
            "address_2": "STE 2",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572924",
            "telephone_number": "856-234-2500",
            "fax_number": "856-234-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SANJIV",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA05916000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7559500",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spatel14368@directvirtua.org",
            "affiliation": "N",
            "address_1": "147 E 3rd St",
            "address_2": "Ste 2",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080572924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.