Individual provider Active NPI

Choudhary Balwan S. Patel, MD

  • Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1003843863
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C127780 Issued in CA
Practice address
4525 E Atherton St
Long Beach, CA 90815-3700
Phone
(562) 961-0155
NPI assigned
Jun 27, 2006
Last updated
Sep 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35039 MA
Psychiatry Physician 2084P0800X C127780 CA Primary

Addresses

Primary practice location

4525 E Atherton St
Long Beach, CA 90815-3700

Mailing address

4525 E Atherton St
Long Beach, CA 90815-3700
Phone (562) 961-0155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141206000002 CA Practitioner - Psychiatry 6103835301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Psychiatry
Education
Other, 1961
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815-3700
Phone (562) 961-0155

4800 E Los Coyotes Diagonal
Long Beach, CA 90815-2897
Phone (562) 506-1313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35039MAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Massachusetts Past Accepting new patients
The Roads Foundation, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD/Endpoint/BFCDAD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1003843863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 E ATHERTON ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153700",
            "telephone_number": "562-961-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 E ATHERTON ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153700",
            "telephone_number": "562-961-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "CHOUDHARY",
        "middle_name": "BALWAN S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "35039",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C127780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.