Pooja V Patel
Individual provider Active NPI Physician Assistant · Spotswood, NJ
NPI 1992396493 · NPPES record last updated Jan 28, 2021
Key facts
- NPI
- 1992396493
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00602100 (NJ)
- Practice address
- 227 Brooklyn Ave
Spotswood, NJ 08884-1352 - Phone
- (760) 855-2511
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
300 Community Dr
Manhasset, NY 11030-3816
300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229
330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550
350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845
475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980
Hospital & facility affiliations
- Staten Island University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220204000752 | NY | Practitioner - Physician Assistant | 2062805542 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00602100 | NJ | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- ppatel69266@northwell.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00602100 | NJ | Yes |
Addresses
Primary practice location
227 Brooklyn Ave
Spotswood, NJ 08884-1352
Mailing address
227 Brooklyn Ave
Spotswood, NJ 08884-1352
Phone (760) 855-2511
Other providers in Spotswood, NJ
- NJ Idtf, LLC
- Njcpx LLC
- One With Nutrition LLC
- Deepa Samir Patel
- Hetal Patel
- Samir G Patel
- Pax Social Services
- Lusine Petrosyan
- Planned Parenthood of Central and Greater Northern NJ
- Jennifer Pollard
All providers in Spotswood, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.