Active NPI
Doreen Marie Patel, APRN
- Family Nurse Practitioner
- Bridgeport, CT
National Provider Identifier
1902083298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 002687
- Practice address
- 1635 Central Ave
Southwest CT Mental Health System
Bridgeport, CT 06610 - Phone
- (203) 551-7660
- NPI assigned
- Jan 29, 2008
- Last updated
- Jan 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 002687 | CT | Primary |
Addresses
Primary practice location
1635 Central Ave
Southwest CT Mental Health System
Bridgeport, CT 06610
Mailing address
1635 Central Ave
Southwest CT Mental Health System
Bridgeport, CT 06610
Phone (203) 551-7660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002687 | CT | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Connecticut | Past | Accepting new patients | |
| State of Connecticut | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Department of Veterans' Affairs, Veterans Home
- Skilled Nursing Facility
- Rocky Hill, CT
- NPI 1205951662
-
dba Southwest Connecticut Mental Health System
- Psychiatric Hospital
- Bridgeport, CT
- NPI 1720013360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1902083298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 CENTRAL AVE",
"address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06610",
"telephone_number": "203-551-7660",
"fax_number": "203-551-7481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 CENTRAL AVE",
"address_2": "SOUTHWEST CT MENTAL HEALTH SYSTEM",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "06610",
"telephone_number": "203-551-7660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "DOREEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-29",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "002687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.