Supal Patel, APN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00964200 Issued in NJ

Practice address

2177 Oak Tree Rd Ste 204
Edison, NJ 08820-1082

Phone

(908) 769-4735

NPI assigned

Jul 10, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Supalkumar Patel Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1780170092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 OAK TREE RD STE 204",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201082",
            "telephone_number": "908-769-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 OAK TREE RD STE 204",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201082",
            "telephone_number": "908-769-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SUPAL",
        "name_prefix": "Mr.",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NJ",
            "license": "26NR16668400",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00964200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUPALKUMAR",
            "last_name": "PATEL",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shreya B Patel, PT, DPT
• Shyamal N Patel
• Snehal Patel, M.D.
• Sonali Patel
• Sonam Patel, APN
• Suresh I Patel, MD
• Surya Patel
• Vandana H Patel
• Varsha Patel, PPH
• Vishnubhai Chimanlal Patel, PHARMACIST

• Family Nurse Practitioner in Edison, NJ
• Providers in Edison, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.