Individual provider Active NPI

Priya Patel, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1932578689
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061814 Issued in PA
Practice address
3737 Market St FL 8
Philadelphia, PA 19104-5545
Phone
(215) 662-3340
Fax
(215) 222-8878
NPI assigned
Sep 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00413000 NJ
Physician Assistant 363A00000X C0005871 MD
Physician Assistant 363A00000X MA061814 PA Primary

Addresses

Primary practice location

3737 Market St FL 8
Philadelphia, PA 19104-5545

Mailing address

3737 Market St FL 8
Philadelphia, PA 19104-5545
Phone (215) 662-3340

Other practice location 1

1411 Madison Park Dr
Glen Burnie, MD 21061-6185
Phone (410) 553-6360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170426000857 NJ Practitioner - Physician Assistant 2769769918 Reassigns benefits to 1 organization
I20201013001354 PA Practitioner - Physician Assistant 2769769918 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0005871MDMDPhysician Assistant
25MP00413000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Sep 21, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 21, 2020 Accepting new patients
Orthonj LLC CurrentSince Sep 1, 2020 Accepting new patients
Orthonj LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

325 Princeton Ave
Princeton, NJ 08540
Phone (609) 924-5044

3737 Market St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-4333

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.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1932578689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARKET ST FL 8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "215-662-3340",
            "fax_number": "215-222-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARKET ST FL 8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "215-662-3340",
            "fax_number": "215-222-8878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 Madison Park Dr",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210616185",
            "country_code": "US",
            "telephone_number": "410-553-6360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00413000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005871",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.