Individual provider Active NPI

Nitiksha Patel, PA-C

  • Medical Physician Assistant
  • Woodbridge, VA
National Provider Identifier
1922548130
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110005650 Issued in VA
Practice address
14010 Smoketown Rd
Suite 117
Woodbridge, VA 22192-4722
Phone
(703) 580-0181
Fax
(703) 897-8763
NPI assigned
Mar 7, 2017
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110005650 VA Primary

Addresses

Primary practice location

14010 Smoketown Rd
Suite 117
Woodbridge, VA 22192-4722

Mailing address

14010 Smoketown Rd
Suite 117
Woodbridge, VA 22192-4722
Phone (703) 580-0181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230530000477 KY Practitioner - Physician Assistant 9638456643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince May 22, 2023 Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 22, 2023 Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1922548130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD",
            "address_2": "SUITE 117",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924722",
            "telephone_number": "703-580-0181",
            "fax_number": "703-897-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD",
            "address_2": "SUITE 117",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924722",
            "telephone_number": "703-580-0181",
            "fax_number": "703-897-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NITIKSHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110005650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.