NPIMap

Individual provider Active NPI

Sandip Subhashbhai Patel, MD

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1750358222
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9501633 Issued in NC
Practice address
3653 Cape Center Drive
Fayetteville, NC 28304
Phone
(910) 426-3332
Fax
(910) 426-3340
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9501633 NC Primary

Addresses

Primary practice location

3653 Cape Center Drive
Fayetteville, NC 28304

Mailing address

PO Box 41806
Fayetteville, NC 28309
Phone (910) 426-3332

Other identifiers 2

IdentifierTypeStateIssuer
11198OtherBCBS
B911198MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130206000352 NC Practitioner - Internal Medicine 4789766841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3653 Cape Ctr Dr
Fayetteville, NC 28304-4457
Phone (910) 426-3332

Hospital & facility affiliations

  • Aveanna Home Health Home health agency, Fayetteville, NC, CCN 347241
  • Well Care Home Health of the Southern Triangle, Inc. Home health agency, Holly Springs, NC, CCN 347336
  • Liberty Home Care, LLC Home health agency, Fayetteville, NC, CCN 347249
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9501633NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Center Medicine PLLC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Delaney Radiologists Group PLLC Past Accepting new patients

Locations

3653 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 426-3332

Organizations & group practices 2

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1750358222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41806",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28309",
            "telephone_number": "910-426-3332",
            "fax_number": "910-426-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 CAPE CENTER DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-426-3332",
            "fax_number": "910-426-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SANDIP",
        "middle_name": "SUBHASHBHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9501633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11198",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B911198",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.