MEDICARE: DR. RUSHITA H PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	25MA08048500	NJ
2	207Q00000X	Family Medicine Physician	242719	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	149296ZDAQ	OTHER	NJ	MEDICARE GROUP MEMBER PTAN
4	A400005048	OTHER	NY	MEDICARE GROUP MEMBER PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588868749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSHITA H PATEL M.D.

Provider Business Mailing Address
First Line	:	1506 FIR CT
Second Line	:
City	:	SOMERSET
State	:	NJ
Zip	:	08873-1873
Country	:	US
Telephone Number	:	201-774-1007
Fax Number	:	718-236-6391

Provider Business Practice Location Address
First Line	:	1835 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5706
Country	:	US
Telephone Number	:	718-236-6025
Fax Number	:	718-236-6391

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	08/26/2024

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Directions to “ DR. RUSHITA H PATEL M.D.” Practice Location

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