NPIMap

Individual provider Active NPI

Kavita M. Patel, MD

  • Diagnostic Radiology Physician
  • Staten Island, NY
National Provider Identifier
1821299116
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
231636 Issued in NY
Practice address
360 Bard Ave
Staten Island, NY 10310-1666
Phone
(718) 876-2000
Fax
(718) 876-2006
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2006-01499 NC
Diagnostic Radiology Physician 2085R0202X 231636 NY Primary
Diagnostic Radiology Physician 2085R0202X 25MA08367500 NJ

Addresses

Primary practice location

360 Bard Ave
Staten Island, NY 10310-1666

Mailing address

360 Bard Ave
Staten Island, NY 10310-1666
Phone (718) 876-2000

Other identifiers 1

IdentifierTypeStateIssuer
0163341MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080807000326 NY Practitioner - Diagnostic Radiology 2567563083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

9525 Queens Blvd
Rego Park, NY 11374-4510
Phone (718) 360-5522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006-01499NCMDDiagnostic Radiology Physician
25MA08367500NJMDDiagnostic Radiology Physician
231636NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 16, 2016 Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Aug 1, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

1220 Hicksville Rd
Seaford, NY 11783

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: kpatel68680@northwell.direct-ci.com

Organizations & group practices 4

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 12

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1821299116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000",
            "fax_number": "718-876-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000",
            "fax_number": "718-876-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAVITA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2006-01499",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "231636",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA08367500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163341",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.