Individual provider Active NPI

Kajol Patel

  • Psychiatric/Mental Health Nurse Practitioner
  • Livonia, MI
National Provider Identifier
1912747247
Registry record updated Jan 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704367329 Issued in MI
Practice address
17177 N Laurel Park Dr Ste 131
Livonia, MI 48152-3952
Phone
(734) 462-3210
NPI assigned
May 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704367329 MI Primary

Addresses

Primary practice location

17177 N Laurel Park Dr Ste 131
Livonia, MI 48152-3952

Mailing address

17177 N Laurel Park Dr Ste 131
Livonia, MI 48152-3952
Phone (734) 462-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260224001140 MI Practitioner - Nurse Practitioner 5991286445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-3952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704367329MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Victor M. Cruz MD, P.C. CurrentSince Feb 1, 2026 Accepting new patients

Locations

17177 N Laurel Park Dr
Ste 131
Livonia, MI 48152
Phone (734) 462-3210

Organizations & group practices 1

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": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768089600000",
    "number": "1912747247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17177 N LAUREL PARK DR STE 131",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523952",
            "telephone_number": "734-462-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17177 N LAUREL PARK DR STE 131",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523952",
            "telephone_number": "734-462-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KAJOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2026-01-11",
        "certification_date": "2026-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704367329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.