NPIMap

Organization Active NPI

Pacific Sleep Disorders Center a California General Partnership

Doing business as Pacific Sleep Disorders Center

  • Sleep Medicine (Internal Medicine) Physician
  • Stockton, CA
National Provider Identifier
1073534103
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
PACIFIC SLEEP DISORDERS CENTER A CALIFORNIA GENERAL PARTNERSHIP
Doing business as
Pacific Sleep Disorders Center
Practice address
1801 E March LN
Suite C310
Stockton, CA 95210-6629
Phone
(209) 465-5731
Fax
(209) 465-0230
NPI assigned
Jul 22, 2006
Last updated
Jan 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Authorized official

Name
Dr. Kirit B Patel, MD
Title
Ceo
Phone
(209) 465-5731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X CA Primary

Addresses

Primary practice location

1801 E March LN
Suite C310
Stockton, CA 95210-6629

Mailing address

1801 E March LN
Suite C310
Stockton, CA 95210-6629
Phone (209) 465-5731

Other identifiers 1

IdentifierTypeStateIssuer
GR0090680MedicaidCA

Other names 1

  • Pacific Sleep Disorders Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040927000457 CA Part B Supplier - Clinic/Group Practice 0446229579 Receives reassigned benefits from 11 practitioners
Practice locations: Lodi, CA; Tracy, CA; Stockton, CA

National Provider Directory

National Provider Directory

Locations

1540 W Kettleman Ln
Ste D
Lodi, CA 95242

1930 Tienda Dr
Lodi, CA 95242

438 W Beverly Pl
#101
Tracy, CA 95376

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1073534103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "SUITE C310",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-465-5731",
            "fax_number": "209-465-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "SUITE C310",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-465-5731",
            "fax_number": "209-465-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SLEEP DISORDERS CENTER A CALIFORNIA GENERAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KIRIT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-465-5731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Sleep Disorders Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.