Individual provider Active NPI

Bansari Gautam Patel, M.D.

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1912167131
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
80437 Issued in GA
Practice address
5909 Peachtree Dunwoody Rd Ste 600
Atlanta, GA 30328-8101
Phone
(770) 928-2276
Fax
(770) 592-2092
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 80437 GA Primary

Addresses

Primary practice location

5909 Peachtree Dunwoody Rd Ste 600
Atlanta, GA 30328-8101

Mailing address

5909 Peachtree Dunwoody Rd Ste 600
Atlanta, GA 30328-8101
Phone (770) 928-2276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151028000709 NC Practitioner - Obstetrics/Gynecology 1254640535

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80437GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Center for Reproductive Medicine Past Accepting new patients
CCRM Atlanta, LLC 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1912167131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 PEACHTREE DUNWOODY RD STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303288101",
            "telephone_number": "770-928-2276",
            "fax_number": "770-592-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 PEACHTREE DUNWOODY RD STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303288101",
            "telephone_number": "770-928-2276",
            "fax_number": "770-592-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "BANSARI",
        "middle_name": "GAUTAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "80437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.