Shamoli Patel, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

57292 Issued in MN

Practice address

20795 Keokuk Ave
Lakeville, MN 55044-6004

Phone

(952) 428-0200

NPI assigned

Jul 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1245608454
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1114239415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20795 KEOKUK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446004",
            "telephone_number": "952-428-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHAMOLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "57292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spatel271273@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "20795 Keokuk Ave",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550446004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Panoramic Perspectives Therapy and Training, PA
• Park Nicollet Health Care Products
• Amy Lynn Parker, MSW, LICSW
• Maria Patch, RN
• Rupa Bharat Patel, PHARM. D.
• Katherine Ann Patras Legut, L.M.F.T.
• McKenna Lynn Patrow
• Paul Otto Jonas Paulsen
• Zachary Paulsen, PHARMD
• Sarah Pavlat

• Family Medicine Physician in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.