Individual provider Active NPI

Komal Hiren Patel, APRN

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1912634551
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11020471 Issued in FL
Practice address
2727 W Dr Martin Luther King Jr Blvd Ste 760
Tampa, FL 33607-6358
Phone
(813) 751-0775
Fax
(813) 377-1729
NPI assigned
Aug 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11020471 FL Primary

Addresses

Primary practice location

2727 W Dr Martin Luther King Jr Blvd Ste 760
Tampa, FL 33607-6358

Mailing address

38135 Market Square Dr
Zephyrhills, FL 33542-7505
Phone (137) 510-7758

Other practice location 1

6312 Sea Lavender Ln
Tampa, FL 33625-3766
Phone (813) 992-5628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221007001095 FL Practitioner - Nurse Practitioner 3375929706 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

2727 W Dr Martin Luther King Jr Blvd
Suite 418
Tampa, FL 33607-6001
Phone (813) 751-0775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11020471FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Clinic, LLC CurrentSince Aug 14, 2023 Accepting new patients
Cardiac Vision LLC CurrentSince Jul 15, 2022 Accepting new patients
Florida Medical Clinic LLC CurrentSince Aug 14, 2023 Accepting new patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients
Ohi West Medical Group II LLC CurrentSince May 1, 2024 Accepting new patients

Locations

2020 Town Center Blvd
Ste C
Brandon, FL 33511
Phone (813) 633-1980

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

2727 W Mlk Blvd
Ste 418
Tampa, FL 33607
Phone (813) 751-0775

2727 W Mlk Blvd
Ste 760
Tampa, FL 33607
Phone (813) 374-0406

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

38135 Market Square Dr
Ste 101
Zephyrhills, FL 33542
Phone (813) 788-7651

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 3

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": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1912634551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "137-510-7758",
            "fax_number": "813-377-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W DR MARTIN LUTHER KING JR BLVD STE 760",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076358",
            "telephone_number": "813-751-0775",
            "fax_number": "813-377-1729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6312 Sea Lavender Ln",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336253766",
            "country_code": "US",
            "telephone_number": "813-992-5628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMAL",
        "middle_name": "HIREN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11020471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.