Individual provider Active NPI

Ami Patel

  • Adult Health Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1770362055
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704349483 Issued in MI
Practice address
306 W Washington Ave Ste 102
Jackson, MI 49201-2141
Phone
(517) 435-0260
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704349483 MI Primary

Addresses

Primary practice location

306 W Washington Ave Ste 102
Jackson, MI 49201-2141

Mailing address

1344 Napa
Canton, MI 48187-7721
Phone (734) 560-7806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260514003411 MI Practitioner - Nurse Practitioner 3274002662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rajendra Mehta, MD, PCGroup PAC ID 3577973833, 5 clinicians

Practice addresses (Care Compare)

306 W Washington Ave
Suite 102
Jackson, MI 49201-2141
Phone (517) 435-0260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704349483MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rajendra Mehta, MD, PC CurrentSince Oct 1, 2023 Accepting new patients
Jackson OB-GYN PLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

306 W Washington Ave
Ste 102
Jackson, MI 49201
Phone (517) 435-0260

Interoperability endpoints

  • Direct secure messaging: apatel892710@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1770362055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 NAPA",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481877721",
            "telephone_number": "734-560-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W WASHINGTON AVE STE 102",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012141",
            "telephone_number": "517-435-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704349483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.