Individual provider Active NPI

Jayesh Kishor Patel, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Tyler, TX
National Provider Identifier
1780840603
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
N2717 Issued in TX
Practice address
1327 Troup Hwy
Tyler, TX 75701-4443
Phone
(903) 510-8840
NPI assigned
Jul 30, 2008
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R0902 KY
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X N2717 TX Primary

Addresses

Primary practice location

1327 Troup Hwy
Tyler, TX 75701-4443

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other identifiers 4

IdentifierTypeStateIssuer
8AM685OtherTXBCBS
75-2616977-113OtherTXTRICARE
TIN PLUS 021OtherTXTRICARE
215969101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101102000980 TX Practitioner - Orthopedic Surgery 3577757616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Northeastern Ohio University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

700 Olympic Plaza Cir
Suite 600
Tyler, TX 75701-1954
Phone (903) 596-3844

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0902KYMDOrthopaedic Surgery Physician
N2717TXMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Apr 1, 2025 Accepting new patients
Christus Trinity Clinic Texas Orthopaedic Surgery CurrentSince Aug 30, 2010 Accepting new patients
Etmc Physician Group Inc. CurrentSince Apr 1, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 30, 2010 Accepting new patients
Mother Frances Hospital Jacksonville Current Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764

2210 Three Lakes Pkwy
Ste 100
Tyler, TX 75703
Phone (903) 747-4050

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

700 Olympic Plaza Cir
Ste 600
Tyler, TX 75701
Phone (903) 594-2666

Interoperability endpoints

  • Direct secure messaging: jpatel1353880@ahs.direct-ci.com

Organizations & group practices 5

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 5

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1780840603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014443",
            "telephone_number": "903-510-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAYESH",
        "middle_name": "KISHOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "R0902",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "N2717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AM685",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-113",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "TIN PLUS 021",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215969101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.