Provider Demographics
NPI:1053331249
Name:PATEL MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:PATEL MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAUSHIK
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-886-1628
Mailing Address - Street 1:2409 BROWNSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-4503
Mailing Address - Country:US
Mailing Address - Phone:412-886-1628
Mailing Address - Fax:412-886-1643
Practice Address - Street 1:2409 BROWNSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-4503
Practice Address - Country:US
Practice Address - Phone:412-886-1628
Practice Address - Fax:412-886-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071045L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018059270003Medicaid
PA10933852OtherCIGNA
PA229426OtherHEALTH AMERICA
PAP002253OtherGATEWAY HEALTH PLAN
PA210966OtherUPMC HEALTH PLAN
PA3378423OtherAETNA HEALTH PLAN
PA149266OtherUNISON MED PLUS
PAP00078916OtherRAILROAD MEDICARE
PA150130OtherUNISON MED PLUS GROUP NUM
PA0018059270004Medicaid
PA075827OtherMEDICARE PTAN
PA155575OtherUMWA UNITED MINE WORKERS
PA1545760OtherBLUE SHIELD
PA229426OtherADVANTRA
PA1545760OtherBLUE SHIELD
PA10933852OtherCIGNA
PA=========OtherDEVON
PA=========OtherUNITED HEALTH CARE
PA0018059270004Medicaid
PA0018059270003Medicaid