Individual provider Active NPI

Priya V. Patel, PA-C

  • Physician Assistant
  • Elgin, IL
National Provider Identifier
1861949034
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005934 Issued in IL
Practice address
77 N Airlite St
Elgin, IL 60123-4912
Phone
(847) 695-3200
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085005934 IL Primary

Addresses

Primary practice location

77 N Airlite St
Elgin, IL 60123-4912

Mailing address

1201 Frederick CT
Elgin, IL 60120-5000
Phone (630) 340-0295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161004001587 IL Practitioner - Physician Assistant 3971891110 Reassigns benefits to 2 organizations
I20260624000148 NJ Practitioner - Physician Assistant 3971891110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 W Gilbert St
Tinton Falls, NJ 07701-4948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince May 28, 2017 Accepting new patients
Cook County CurrentSince May 28, 2017 Accepting new patients
Cepamerica Illinois LLP CurrentSince Oct 1, 2016 Accepting new patients
Cepamerica Illinois LLP CurrentSince Oct 1, 2016 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1900 W Polk St
Ste 1200
Chicago, IL 60612

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

Interoperability endpoints

  • Direct secure messaging: ppatel261527@epicdirect.rwjbh.org

Organizations & group practices 7

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1861949034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 FREDERICK CT",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601205000",
            "telephone_number": "630-340-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N AIRLITE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234912",
            "telephone_number": "847-695-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYA",
        "middle_name": "V.",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.