1053331249 NPI number — PATEL MEDICAL ASSOCIATES LLC

Table of content: (NPI 1053331249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053331249 NPI number — PATEL MEDICAL ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATEL MEDICAL ASSOCIATES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053331249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2409 BROWNSVILLE ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15210-4503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-886-1628
Provider Business Mailing Address Fax Number:
412-886-1643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2409 BROWNSVILLE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15210-4503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-886-1628
Provider Business Practice Location Address Fax Number:
412-886-1643
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
KAUSHIK
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
412-886-1628

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD071045L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0018059270003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10933852 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 229426 . This is a "HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P002253 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 210966 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3378423 . This is a "AETNA HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 149266 . This is a "UNISON MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00078916 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 150130 . This is a "UNISON MED PLUS GROUP NUM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018059270004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 075827 . This is a "MEDICARE PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 155575 . This is a "UMWA UNITED MINE WORKERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1545760 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 229426 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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