Individual provider Active NPI

Palak Patel, PA

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1952641987
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0738 Issued in ND
Practice address
4656 40TH Ave S
Fargo, ND 58104
Phone
(701) 234-8860
NPI assigned
Feb 28, 2013
Last updated
Sep 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106926 FL
Physician Assistant 363A00000X PAC0738 ND Primary

Addresses

Primary practice location

4656 40TH Ave S
Fargo, ND 58104

Mailing address

4656 40TH Ave S
Fargo, ND 58104-4397
Phone (701) 234-8860

Other practice location 1

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-3432

Other practice location 2

1950 Laurel Manor Dr
Suite 224
The Villages, FL 32162-5603
Phone (352) 751-6565

Other practice location 3

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-3432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20181130002660 ND Practitioner - Physician Assistant 6507002961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

332 2ND Ave N
Wahpeton, ND 58075-4528
Phone (701) 642-7000

4656 40TH Ave S
Fargo, ND 58104-4397

520 Chautauqua Blvd
Valley City, ND 58072-3145
Phone (701) 845-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106926FLMDPhysician Assistant
PAC0738NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 11, 2018 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 11, 2018 Accepting new patients
Health First Internal Medicine Associates, LLC Past Accepting new patients

Locations

2603 E Broadway Ave
Bismarck, ND 58501
Phone 7013235222 ext. 5733

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

4656 40th Ave S
Fargo, ND 58104
Phone (701) 234-2431

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

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 5

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": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1952641987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 40TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044397",
            "telephone_number": "701-234-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 40TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-234-8860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Duke Medicine Cir",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277104000",
            "country_code": "US",
            "telephone_number": "919-684-3432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 Laurel Manor Dr",
            "address_2": "Suite 224",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321625603",
            "country_code": "US",
            "telephone_number": "352-751-6565",
            "fax_number": "352-205-7777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Duke Medicine Cir",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277104000",
            "country_code": "US",
            "telephone_number": "919-684-3432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PALAK",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106926",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.