Individual provider Active NPI

Dhara Patel, DO

  • Internal Medicine Physician
  • Riverside, CA
National Provider Identifier
1043707128
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A17868 Issued in CA
Practice address
4646 Brockton Ave Ste 202
Riverside, CA 92506-0104
Phone
(951) 774-2881
NPI assigned
Apr 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A17868 CA Primary

Addresses

Primary practice location

4646 Brockton Ave Ste 202
Riverside, CA 92506-0104

Mailing address

4646 Brockton Ave Ste 202
Riverside, CA 92506-0104
Phone (951) 774-2881

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220317002090 CA Practitioner - Osteopathic Manipulative Medicine 1557756160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Raincross Medical Group IncGroup PAC ID 9638079304, 6 clinicians

Practice addresses (Care Compare)

4646 Brockton Ave
Suite 203
Riverside, CA 92506-0104
Phone (951) 774-2881

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17868CAMDDental Hygienist
20A17868CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raincross Medical Group Inc CurrentSince Nov 25, 2024 Accepting new patients

Locations

4646 Brockton Ave
Ste 202-1
Riverside, CA 92506
Phone (951) 394-2328

4646 Brockton Ave
Ste 202
Riverside, CA 92506
Phone (909) 774-2800

4646 Brockton Ave
Ste 203
Riverside, CA 92506
Phone (951) 394-7028

4646 Brockton Ave
Ste 203-4
Riverside, CA 92506

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dhara.patel@403277232537604.direct.elationemr.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1043707128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 202",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060104",
            "telephone_number": "951-774-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 BROCKTON AVE STE 202",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925060104",
            "telephone_number": "951-774-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DHARA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A17868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.