Individual provider Active NPI

Pooja Patel, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1982013330
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117635 Issued in FL
Practice address
1541 Medical Dr
Tallahassee, FL 32308-4615
Phone
(850) 431-6824
NPI assigned
Aug 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 017856 NY
Physician Assistant 363A00000X PA9117635 FL Primary

Addresses

Primary practice location

1541 Medical Dr
Tallahassee, FL 32308-4615

Mailing address

475 Enterprise Dr
Ste 202
Royersford, PA 19468-1265
Phone (610) 374-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, 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
I20161102000614 FL Practitioner - Physician Assistant 1951522101 Reassigns benefits to 3 organizations
I20220303000221 PA Practitioner - Physician Assistant 1951522101 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017856NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Oct 10, 2016 Accepting new patients
Tallahassee Memorial Healthcare Inc. Current Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Feb 1, 2022 Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Oct 10, 2016 Accepting new patients

Locations

178 Lefall Dr
Quincy, FL 32351
Phone (850) 875-3600

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1541 Medical Dr
Tallahassee, FL 32308
Phone (850) 431-7801

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

475 Enterprise Dr
Ste 202
Royersford, PA 19468
Phone (610) 674-4401

100 E Lancaster Ave
Ste 252
Wynnewood, PA 19096
Phone (610) 896-7360

Interoperability endpoints

  • Direct secure messaging: poojapatel@ddal.allscriptsdirect.net

Organizations & group practices 8

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": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1982013330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ENTERPRISE DR",
            "address_2": "STE 202",
            "city": "ROYERSFORD",
            "state": "PA",
            "postal_code": "194681265",
            "telephone_number": "610-374-4401",
            "fax_number": "610-374-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084615",
            "telephone_number": "850-431-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POOJA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017856",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.