Individual provider Active NPI

Kishen Patel, MD, MBA

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1992201545
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
326392 Issued in LA
Practice address
1000 Amsterdam Ave
New York, NY 10025-2208
Phone
(212) 523-4000
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 326392 LA Primary

Addresses

Primary practice location

1000 Amsterdam Ave
New York, NY 10025-2208

Mailing address

270 17TH St NW Unit 1512
Atlanta, GA 30363-1213
Phone (706) 817-3005

Other practice location 1

Grady Memorial Hospital
80 Jesse Hill Jr Drive SE
Atlanta, GA 30303
Phone (404) 616-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 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
I20210727000033 LA Practitioner - Emergency Medicine 3870843568 Reassigns benefits to 1 organization
I20250409003729 TX Practitioner - Emergency Medicine 3870843568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Icahn School of Medicine at Mount Sinai, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians
Ies Central Texas PLLCGroup PAC ID 3476922576, 33 clinicians

Practice addresses (Care Compare)

2400 Hospital Dr
Bossier City, LA 71111-2385
Phone (318) 212-7000

2710 W Hackberry LN
Anna, TX 75409-2573
Phone (214) 831-2600

Hospital & facility affiliations

  • Texoma Medical Center Hospital, Denison, TX, CCN 450324
  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
326392LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Level One Emergency Physicians LLC Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Jun 21, 2021 Accepting new patients
Willis Knighton Medical Center, Inc. PastSince Sep 27, 2020 Accepting new patients
Uhs of Texoma, Inc Past Accepting new patients

Locations

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

2710 W Hackberry Ln
Anna, TX 75409
Phone (214) 831-2600

5016 US Highway 75
Denison, TX 75020
Phone (855) 222-9637

4226 N US Highway 75
Sherman, TX 75090
Phone (903) 487-0857

Organizations & group practices 5

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.

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1992201545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 17TH ST NW UNIT 1512",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303631213",
            "telephone_number": "706-817-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252208",
            "telephone_number": "212-523-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Grady Memorial Hospital",
            "address_2": "80 Jesse Hill Jr Drive SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30303",
            "country_code": "US",
            "telephone_number": "404-616-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KISHEN",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "326392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.