Individual provider Active NPI

Khusbu Patel, NP

  • Gerontology Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1962107953
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN291127 Issued in GA
Practice address
771 Old Norcross Rd Ste 200
Lawrenceville, GA 30046-4980
Phone
(770) 339-1387
Fax
(770) 962-7868
NPI assigned
Mar 31, 2023
Last updated
Mar 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN291127 GA Primary

Addresses

Primary practice location

771 Old Norcross Rd Ste 200
Lawrenceville, GA 30046-4980

Mailing address

771 Old Norcross Rd Ste 200
Lawrenceville, GA 30046-4980
Phone (770) 339-1387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230418001965 GA Practitioner - Nurse Practitioner 8820463144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Endocrinology and Diabetes, PCGroup PAC ID 7618965146, 11 clinicians

Practice addresses (Care Compare)

771 Old Norcross Rd
Suite 200
Lawrenceville, GA 30046-4980
Phone 7703391387229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Endocrinology and Diabetes, PC CurrentSince Apr 4, 2023 Accepting new patients
Openloop Healthcare Partners PC PastSince Apr 4, 2023 Accepting new patients

Locations

771 Old Norcross Rd
Ste 200
Lawrenceville, GA 30046
Phone (770) 339-1387

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.400261

Organizations & group practices 2

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": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1962107953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464980",
            "telephone_number": "770-339-1387",
            "fax_number": "770-962-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464980",
            "telephone_number": "770-339-1387",
            "fax_number": "770-962-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KHUSBU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN291127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.