Individual provider Active NPI

Anjali D Patel, D.O.

  • Interventional Pain Medicine Physician
  • Clifton, NJ
National Provider Identifier
1891818530
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
25MB08416900 Issued in NJ
Practice address
1060 Clifton Ave
Clifton, NJ 07013-3638
Phone
(973) 779-7354
Fax
(973) 779-7385
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OT010795 PA
Anesthesiology Physician 207L00000X 25MB08416900 NJ
Interventional Pain Medicine Physician 208VP0014X 25MB08416900 NJ Primary

Addresses

Primary practice location

1060 Clifton Ave
Clifton, NJ 07013-3638

Mailing address

1060 Clifton Ave
Clifton, NJ 07013-3638
Phone (973) 779-7354

Other identifiers 2

IdentifierTypeStateIssuer
25MB08416900OtherNJSTATE LICENSE
0178233MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20090107000185 NJ Practitioner - Interventional RadiologyPractitioner - AnesthesiologyPractitioner - Pain ManagementPractitioner - Interventional Pain Management 0941363667 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Mount Prospect Ave
Suite 209
Clifton, NJ 07013-1900
Phone (862) 238-8250

Hospital & facility affiliations

  • Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT010795PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen County Improvement Authority CurrentSince Nov 8, 2023 Accepting new patients
Bergen County Improvement Authority Interventional Pain Medicine CurrentSince Nov 8, 2023 Accepting new patients
Interventional Pain Consultants of New Jersey, PA Interventional Pain Medicine Past Accepting new patients

Locations

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

Organizations & group practices 5

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 1

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1891818530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133638",
            "telephone_number": "973-779-7354",
            "fax_number": "973-779-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133638",
            "telephone_number": "973-779-7354",
            "fax_number": "973-779-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANJALI",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "OT010795",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MB08416900",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MB08416900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MB08416900",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0178233",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.