Individual provider Active NPI

Ekta M Patel, M.D.

  • Pediatrics Physician
  • Bohemia, NY
National Provider Identifier
1760708887
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
254052 Issued in NY
Practice address
3920 Veterans Memorial Hwy Ste 8
Bohemia, NY 11716-1074
Phone
(631) 563-8193
Fax
(631) 563-8191
NPI assigned
Apr 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 254052 NY Primary

Addresses

Primary practice location

3920 Veterans Memorial Hwy Ste 8
Bohemia, NY 11716-1074

Mailing address

500 Commack Rd
Commack, NY 11725-5020
Phone (631) 675-2125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170713003293 NY Practitioner - Pediatric Medicine 7214207810 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254052NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Pediatrics CurrentSince Jun 26, 2017 Accepting new patients

Locations

3920 Veterans Memorial Hwy
Ste 8
Bohemia, NY 11716
Phone (631) 563-8193

500 Commack Rd
Commack, NY 11725
Phone (516) 809-9666

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

285 W Main St
Sayville, NY 11782
Phone (631) 563-8190

285 W Main St
Ste 104
Sayville, NY 11782
Phone (631) 563-8190

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ekta.patel@sbcm.cernerdirect.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1760708887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COMMACK RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255020",
            "telephone_number": "631-675-2125",
            "fax_number": "631-675-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 VETERANS MEMORIAL HWY STE 8",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161074",
            "telephone_number": "631-563-8193",
            "fax_number": "631-563-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "EKTA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "254052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

Verify at the official NPI Registry.