NPIMap

Individual provider Active NPI

Jyoti Patel, MD

  • Pain Medicine (Anesthesiology) Physician
  • St Augustine, FL
National Provider Identifier
1801828553
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME61180 Issued in FL
Practice address
105 Southpark Blvd
Ste C-300
St Augustine, FL 32086-4162
Phone
(904) 808-7246
Fax
(904) 808-7090
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X ME61180 FL Primary

Addresses

Primary practice location

105 Southpark Blvd
Ste C-300
St Augustine, FL 32086-4162

Mailing address

105 Southpark Blvd
Ste C300
St Augustine, FL 32086-4162
Phone (904) 808-7246

Other identifiers 4

IdentifierTypeStateIssuer
15162OtherFLBLUE CROSS PROVIDER NUMBE
34189OtherFLMEDICARE GRP NUMBER
05336700OtherFLAETNA PROV NUMBER
370492100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000535 FL Practitioner - Interventional Pain Management 5698753028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ouch, PAGroup PAC ID 4082681747, 3 clinicians

Practice addresses (Care Compare)

105 Southpark Blvd
Suite C300
Saint Augustine, FL 32086-4162
Phone (904) 808-7246

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.36 of 100Reported as group
Quality
96.2
Promoting interoperability
100
Improvement activities
40
Cost
63.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME61180FLMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ouch, PA CurrentSince Jun 23, 2002 Accepting new patients

Locations

800 Zeagler Dr
Ste 510
Palatka, FL 32177
Phone (386) 325-2663

105 Southpark Blvd
Ste C300
St Augustine, FL 32086
Phone (904) 797-2663

Interoperability endpoints

  • Direct secure messaging: jpatel743338@direct.shands.ufl.edu
  • Direct secure messaging: ppc@pcnt.streamlinemddirect.com

Organizations & group practices 1

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.

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1801828553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "STE C300",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-808-7246",
            "fax_number": "904-808-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "STE C-300",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-808-7246",
            "fax_number": "904-808-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JYOTI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME61180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "15162",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP NUMBER",
            "identifier": "34189",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROV NUMBER",
            "identifier": "05336700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370492100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.