MEDICARE: DR. ASHOK JIVANLAL 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	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	52194	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00057680	OTHER	MA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04-05063	OTHER	MA	EVERCARE
2	0030542	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
3	4488345	OTHER	MA	AETNA
4	030506866	OTHER	MA	CIGNA AARP COMMONWLTH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	052194	OTHER	MA	TUFTS HEALTH PLAN
8	64369	OTHER	MA	HARVARD PILGRIM HLTH CARE
9	J30545	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1902825441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHOK JIVANLAL PATEL M.D.

Provider Business Mailing Address
First Line	:	2100 DORCHESTER AVE
Second Line	:	SETON MEDICAL BUILDING-SUITE 303
City	:	DORCHESTER
State	:	MA
Zip	:	02124
Country	:	US
Telephone Number	:	617-296-0720
Fax Number	:	617-296-5166

Provider Business Practice Location Address
First Line	:	2110 DORCHESTER AVE
Second Line	:	SUITE 303
City	:	DORCHESTER CENTER
State	:	MA
Zip	:	02124-5628
Country	:	US
Telephone Number	:	617-296-0720
Fax Number	:	617-296-5166

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/06/2012

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Directions to “ DR. ASHOK JIVANLAL PATEL M.D.” Practice Location

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