Pathik Patel, PT
Individual provider Active NPI Physical Therapist · Brambleton, VA
NPI 1780187484 · NPPES record last updated Mar 9, 2018
Key facts
- NPI
- 1780187484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305211741 (VA)
- Practice address
- 42365 Soave Dr Ste 200
Brambleton, VA 20148-4888 - Phone
- (571) 349-3116
- NPI assigned
- Mar 9, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jackson Clinics Limited Partnership
Practice addresses (Care Compare)
42365 Soave Dr
Suite 200
Brambleton, VA 20148-4888
Phone (571) 349-3116
8550 Route 29
Fairfax, VA 22031-1519
Phone (703) 208-1002
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180413000227 | VA | Practitioner - Physical Therapist in Private Practice | 2163785783 | Reassigns benefits to 1 organization |
| I20180614000018 | DC | Practitioner - Physical Therapist in Private Practice | 2163785783 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Clinics Limited Partnership | Physical Therapist | Current |
Accepting new patients |
| The Jackson Clinics LLC | Physical Therapist | Past |
Accepting new patients |
Locations
43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920
42365 Soave Dr
Ste 200
Brambleton, VA 20148
Phone (571) 349-3116
12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305211741 | VA | Yes |
Addresses
Primary practice location
42365 Soave Dr Ste 200
Brambleton, VA 20148-4888
Mailing address
42365 Soave Dr Ste 200
Brambleton, VA 20148-4888
Other providers in Brambleton, VA
- Motionworks Professional Limited Liability Company
- Jacelyn Norris
- Marie Eliane Meyedjen Noutio
- Amy Sarver Oppelt
- Viraj Pandya Chang
- Shilpi Pathak
- Kelsey Preston
- Lindsey Anne Purcell
- Analisse Reyes Collazo
- Katherine Sanders
All providers in Brambleton, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.