Provider Demographics
NPI:1083664015
Name:PATEL, UJJAVAL M (MD)
Entity Type:Individual
Prefix:DR
First Name:UJJAVAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-253-3000
Mailing Address - Fax:913-663-2980
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-253-3000
Practice Address - Fax:913-663-2980
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000160637207RC0000X
KS0428804207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100383170AMedicaid
MO205149800Medicaid
KSK67A659AMedicare PIN
MOMA2311006Medicare PIN
KSKA1701006Medicare PIN
MOK67A659Medicare PIN
KS100383170AMedicaid
MO450A659AMedicare PIN
MOMA2310006Medicare PIN
KS45A659DMedicare PIN