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Physician Compare National (NPI:1174018972)

HEALTHCARE PROVIDER: MIRAL N PATEL CNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1174018972
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5799034765
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20200207001532
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name PATEL
Individual professional last name
Provider First Name MIRAL
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2017
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name CG MEDICAL ASSOCIATES INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 6608052196
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 54
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 7683 MALL RD
Group Practice or individual's line 1 address
Line 2 Street Address UNIT B
Group Practice or individual's line 2 address
City FLORENCE
Group Practice or individual's city
State KY
Group Practice or individual's state
Zip Code 410421590
Group Practice or individual's zip code (9 digits when available)
Phone Number 8598171320
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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