Individual provider Active NPI

Chandni Patel, MD

  • Pediatric Cardiology Physician
  • New Brunswick, NJ
National Provider Identifier
1760740617
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
25MA10647100 Issued in NJ
Practice address
254 Easton Ave
Mob2 Pediatric Cardiology
New Brunswick, NJ 08901
Phone
(732) 846-2855
Fax
(732) 745-4680
NPI assigned
Apr 29, 2012
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 25MA10647100 NJ Primary

Addresses

Primary practice location

254 Easton Ave
Mob2 Pediatric Cardiology
New Brunswick, NJ 08901

Mailing address

254 Easton Ave
Mob2 Pediatric Cardiology
New Brunswick, NJ 08901
Phone (732) 846-2855

Other practice location 1

9000 W Wisconsin Ave
Milwaukee, WI 53226
Phone (414) 266-6457

Other identifiers 1

IdentifierTypeStateIssuer
1760740617MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, PA, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181109000277 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 4688956931 Reassigns benefits to 1 organization
I20210216001050 PA Practitioner - Cardiovascular Disease (Cardiology) 4688956931 Reassigns benefits to 1 organization
I20210216001185 NJ Practitioner - Cardiovascular Disease (Cardiology) 4688956931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10647100NJMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates of New Jersey PC CurrentSince Oct 29, 2020 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Oct 29, 2020 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc Pediatric Cardiology CurrentSince Oct 29, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Sep 22, 2018 Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Oct 29, 2020 Accepting new patients
Childrens Health Care Associates, Inc Past Accepting new patients

Locations

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

254 Easton Ave
#2
New Brunswick, NJ 08901
Phone (732) 846-2855

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1335657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1760740617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "address_2": "MOB2 PEDIATRIC CARDIOLOGY",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-846-2855",
            "fax_number": "732-745-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "address_2": "MOB2 PEDIATRIC CARDIOLOGY",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-846-2855",
            "fax_number": "732-745-4680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53226",
            "country_code": "US",
            "telephone_number": "414-266-6457",
            "fax_number": "414-266-2294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "CHANDNI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-29",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NJ",
            "license": "25MA10647100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760740617",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.