Individual provider Active NPI

Jason Eric Patel, M.D.

  • Psychiatry Physician
  • St Petersburg, FL
National Provider Identifier
1932581055
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME140827 Issued in FL
Practice address
1515 22ND Ave N
St Petersburg, FL 33704-3113
Phone
(727) 322-4227
NPI assigned
Jun 25, 2015
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301107911 MI
Psychiatry Physician 2084P0800X ME140827 FL Primary

Addresses

Primary practice location

1515 22ND Ave N
St Petersburg, FL 33704-3113

Mailing address

PO Box 13343
St Petersburg, FL 33733-3343
Phone (727) 203-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200828001727 FL Practitioner - Psychiatry 7416267547 Reassigns benefits to 2 organizations
I20210422000810 MI Practitioner - Psychiatry 7416267547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of South Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Health ClinicsGroup PAC ID 6305129693, 6 clinicians

Practice addresses (Care Compare)

1515 22ND Ave N
St Petersburg, FL 33704-3113
Phone (727) 322-4227

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME140827FLMDPsychiatry Physician
4301107911MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Psychiatry PLLC Psychiatry CurrentSince Aug 1, 2020 Accepting new patients
Copper Country Community Mental Health Services CurrentSince Apr 15, 2021 Accepting new patients
Affiliated Health Clinics CurrentSince Feb 7, 2024 Accepting new patients
Copper Country Community Mental Health Services Board CurrentSince Apr 15, 2021 Accepting new patients

Locations

1515 22nd Ave N
St Petersburg, FL 33704
Phone (727) 322-4227

2931 1st Ave S
St Petersburg, FL 33712
Phone (727) 344-9933

3690 W Gandy Blvd
Tampa, FL 33611
Phone (412) 477-0400

515 Quartz St
Ontonagon, MI 49953
Phone (906) 884-4804

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADGHAD

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1932581055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13343",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337333343",
            "telephone_number": "727-203-5035",
            "fax_number": "727-205-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 22ND AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043113",
            "telephone_number": "727-322-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JASON",
        "middle_name": "ERIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301107911",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME140827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.