Active NPI
Dhirendra Jashbhai Patel, MD
- Radiation Oncology Physician
- Prescott, AZ
National Provider Identifier
1790773893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 17169
- Practice address
- 1100 Gail Gardner Way
Prescott, AZ 86305-1690 - Phone
- (928) 776-1040
- Fax
- (928) 776-1041
- NPI assigned
- Oct 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 17169 | AZ | Primary |
Addresses
Primary practice location
1100 Gail Gardner Way
Prescott, AZ 86305-1690
Mailing address
1760 E River Rd Ste 350
Tucson, AZ 85718-5999
Phone (520) 519-7775
Other practice location 1
7825 E Florentine Rd
Prescott Valley, AZ 86314-2217
Phone (928) 775-0810
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0347980 | Other | AZ | BCBS |
| 920002679 | Other | AZ | RR MEDICARE |
| 275132 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568592000000",
"number": "1790773893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 E RIVER RD STE 350",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857185999",
"telephone_number": "520-519-7775",
"fax_number": "520-519-7910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 GAIL GARDNER WAY",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863051690",
"telephone_number": "928-776-1040",
"fax_number": "928-776-1041"
}
],
"practiceLocations": [
{
"address_1": "7825 E Florentine Rd",
"address_purpose": "LOCATION",
"city": "Prescott Valley",
"state": "AZ",
"postal_code": "863142217",
"country_code": "US",
"telephone_number": "928-775-0810",
"fax_number": "928-775-0827",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "DHIRENDRA",
"middle_name": "JASHBHAI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-12",
"last_updated": "2019-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "AZ",
"license": "17169",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "AZ0347980",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "920002679",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "275132",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.