Individual provider Active NPI

Bansri M. Patel, MD

  • Dermatology Physician
  • Lawrenceville, GA
National Provider Identifier
1801538897
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
111676 Issued in GA
Practice address
721 Wellness Way Ste 210
Lawrenceville, GA 30046-3304
Phone
(770) 682-2500
NPI assigned
Apr 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 111676 GA Primary

Addresses

Primary practice location

721 Wellness Way Ste 210
Lawrenceville, GA 30046-3304

Mailing address

721 Wellness Way Ste 210
Lawrenceville, GA 30046-3304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230928003915 PA Order and Referring Only - DermatologyPractitioner - Dermatology 7618321308

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": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1801538897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 WELLNESS WAY STE 210",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 WELLNESS WAY STE 210",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463304",
            "telephone_number": "770-682-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BANSRI",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-10",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "111676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.