Active NPI
Meera Nilesh Patel
- Physician Assistant
- Portland, OR
National Provider Identifier
1962978593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA201930
- Practice address
- 12518 NE Airport Way
Portland, OR 97230-1078 - Phone
- (503) 256-2992
- Fax
- (503) 258-0717
- NPI assigned
- Oct 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 56165 | CA | |
| Family Medicine Physician | 207Q00000X | PA201930 | OR | |
| Physician Assistant | 363A00000X | PA201930 | OR | Primary |
Addresses
Primary practice location
12518 NE Airport Way
Portland, OR 97230-1078
Mailing address
12518 NE Airport Way
Portland, OR 97230-1078
Phone (503) 256-2992
Other practice location 1
22030 Sherman Way Ste 101
Canoga Park, CA 91303-1844
Phone (818) 312-9101
Other practice location 2
4920 N Interstate Ave
Portland, OR 97217-3653
Phone (503) 215-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA201930 | OR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1962978593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12518 NE AIRPORT WAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972301078",
"telephone_number": "503-256-2992",
"fax_number": "503-258-0717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12518 NE AIRPORT WAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972301078",
"telephone_number": "503-256-2992",
"fax_number": "503-258-0717"
}
],
"practiceLocations": [
{
"address_1": "22030 Sherman Way Ste 101",
"address_purpose": "LOCATION",
"city": "Canoga Park",
"state": "CA",
"postal_code": "913031844",
"country_code": "US",
"telephone_number": "818-312-9101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4920 N Interstate Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972173653",
"country_code": "US",
"telephone_number": "503-215-3300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "MEERA",
"middle_name": "NILESH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-22",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "56165",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "PA201930",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA201930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.