Provider Demographics
NPI:1649256843
Name:PATEL, KAUSHIK P (MD)
Entity type:Individual
Prefix:
First Name:KAUSHIK
Middle Name:P
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 1:2409 BROWNSVILLE RD
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 RD
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:412-886-9803
Practice Address - Fax:412-886-1918
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071045L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA210966OtherUPMC HEALTH PLAN
PA229426OtherHEALTH AMERICA
PA0018059270004Medicaid
PA3378423OtherAETNA
PA149266OtherMEDPLUS HEALTH PLAN
PA155575OtherUMWA UNITED MINE WORKERS
PAP002253OtherGATEWAY HEALTH PLAN
PA10933852OtherCIGNA INSURANCE CO
PA0018059270003Medicaid
PA1545760OtherBLUE SHIELD OF PA
PAP00078916OtherRAILROAD MEDICARE
PA210966OtherUPMC HEALTH PLAN
PA10933852OtherCIGNA INSURANCE CO
PAH18145Medicare UPIN