Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin Patel, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1205302593

Kevin Patel, PHYSICIANASSISTANT is a Physician Assistant in Jericho, New York. Qualified in 2018, 8 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
Specialties on file
2

Practice location Address checks out

555 N Broadway
Jericho, NY 11753-2134
Phone: (516) 597-5070
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)
Physician Assistant Taxonomy 363A00000X · Licence 022935 (NY)

Record details

NPI number1205302593
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedOctober 15, 2018
Last updated in NPPESFebruary 28, 2022
Certification dateFebruary 28, 2022
Mailing address555 N Broadway, Jericho, NY 11753-2134

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Not indicated
Practice locations16 on file with Medicare

Other providers in Jericho