Individual provider Active NPI

Dharmistha Patel

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1750072773
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041469154 Issued in IL
Practice address
4355 W Hollywood Ave
Chicago, IL 60646-5901
Phone
(773) 580-2402
NPI assigned
May 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041469154 IL Primary

Addresses

Primary practice location

4355 W Hollywood Ave
Chicago, IL 60646-5901

Mailing address

4355 W Hollywood Ave
Chicago, IL 60646-5901
Phone (773) 580-2402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230816003101 MA Practitioner - Nurse Practitioner 4284096645 Reassigns benefits to 1 organization
I20230816003605 RI Practitioner - Nurse Practitioner 4284096645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franklin Pain Associates LLCGroup PAC ID 5991804114, 9 clinicians

Practice addresses (Care Compare)

750 Union St
Lowr Level
Franklin, MA 02038-2539
Phone (508) 541-0004

Hospital & facility affiliations

  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.39 of 100Reported as group
Quality
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041469154ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Pain Associates LLC CurrentSince Aug 1, 2023 Accepting new patients
Warwick Pain Associates LLC CurrentSince Aug 1, 2023 Accepting new patients
C&S Anesthesia LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

750 Union St
Lowr
Franklin, MA 02038
Phone (508) 541-0004

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

2870 Post Rd
Warwick, RI 02886
Phone (401) 298-8869

Organizations & group practices 3

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 1

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1750072773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 W HOLLYWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465901",
            "telephone_number": "773-580-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 W HOLLYWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465901",
            "telephone_number": "773-580-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHARMISTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041469154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.