Individual provider Active NPI

Kiran D Patel, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Monmouth Junction, NJ
National Provider Identifier
1790417152
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01327200 Issued in NJ
Practice address
407 Royal Oaks CT
Monmouth Junction, NJ 08852-2202
Phone
(551) 697-9971
NPI assigned
Jun 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 26NJ01327200 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01327200 NJ Primary

Addresses

Primary practice location

407 Royal Oaks CT
Monmouth Junction, NJ 08852-2202

Mailing address

1527 State Route 27 Ste 1600
Somerset, NJ 08873-3905
Phone (551) 697-9971

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230209002464 NJ Practitioner - Nurse Practitioner 6103298617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shivshakti Psychiatry Care LLCGroup PAC ID 8325493315, 4 clinicians

Practice addresses (Care Compare)

1527 State Route 27
Suite 1600
Somerset, NJ 08873-3905
Phone (732) 712-3787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01327200NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stress Care of New Jersey, LLC CurrentSince Oct 12, 2022 Accepting new patients
Stress Care of New Jersey, LLC CurrentSince Oct 12, 2022 Accepting new patients
Shivshakti Psychiatry Care LLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

4122 Route 516
Matawan, NJ 07747
Phone (732) 679-4500

1527 State Route 27
Ste 1600
Somerset, NJ 08873
Phone (347) 740-4968

Organizations & group practices 3

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": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1790417152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 STATE ROUTE 27 STE 1600",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733905",
            "telephone_number": "551-697-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 ROYAL OAKS CT",
            "city": "MONMOUTH JUNCTION",
            "state": "NJ",
            "postal_code": "088522202",
            "telephone_number": "551-697-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KIRAN",
        "middle_name": "D",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-25",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01327200",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01327200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monmouth Junction, NJ

Sources for this page

Verify at the official NPI Registry.