Provider Demographics
NPI:1720063134
Name:MAHESH PATEL, MD,PC
Entity Type:Organization
Organization Name:MAHESH PATEL, MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-685-0622
Mailing Address - Street 1:PO BOX 26124
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66225-6124
Mailing Address - Country:US
Mailing Address - Phone:913-685-0622
Mailing Address - Fax:913-685-0622
Practice Address - Street 1:1509 NE PARVIN RD
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2304
Practice Address - Country:US
Practice Address - Phone:816-283-3396
Practice Address - Fax:913-685-0622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD 1030402084P0800X
MO111019364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Not Answered364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO42541890Medicaid
MO206659823Medicaid
MOP451590Medicare ID - Type UnspecifiedMAHESH PATEL, MD
MO206659823Medicaid
MOP45C246Medicare ID - Type UnspecifiedMEENA PATEL, CNS
MOE 24665Medicare UPIN