Individual provider Active NPI

Dhara Patel, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Montclair, NJ
National Provider Identifier
1770103004
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA12734100 Issued in NJ
Practice address
1 Bay Ave
Montclair, NJ 07042-4837
Phone
(973) 429-6196
NPI assigned
Apr 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA12734100 NJ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA12734100 NJ Primary

Addresses

Primary practice location

1 Bay Ave
Montclair, NJ 07042-4837

Mailing address

55 Morris Ave
Springfield, NJ 07081-1426

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
I20250801001515 NJ Practitioner - Endocrinology 2860881455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Enlyv Clinics LLCGroup PAC ID 7113346057, 6 clinicians

Practice addresses (Care Compare)

2 Lincoln Hwy
Suite 508
Edison, NJ 08820-3961
Phone (908) 505-2327

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12734100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Enlyv Clinics LLC CurrentSince Feb 1, 2026 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

2 State Route 27
Ste 508
Edison, NJ 08820
Phone (908) 505-2327

28 Wills Way
Piscataway, NJ 08854
Phone (908) 505-2327

908 Oak Tree Ave
Ste R
South Plainfield, NJ 07080
Phone (908) 222-8980

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCFCCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1770103004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12734100",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA12734100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.