Shivam Dixit Patel, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A24060 Issued in CA

Practice address

200 W Arbor Dr
San Diego, CA 92103-9000

Phone

(858) 657-5272

NPI assigned

Mar 2, 2020

Reactivated

Apr 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physical Medicine and Rehabilitation

Education

Midwestern University, Chicago College of Osteopathic Med, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Illinois Pain Treatment Institute, LTD

  • Interventional Pain Medicine Physician
  • Elgin, IL
  • NPI 1295811479
  Medicare reassignment
• Pain & Spine Institute, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Joliet, IL
  • NPI 1578610176
  Medicare reassignment

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1114551876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "858-657-5272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 E Erie St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113167",
            "country_code": "US",
            "telephone_number": "312-238-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113055",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVAM",
        "middle_name": "DIXIT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "deactivation_date": "2021-03-23",
        "reactivation_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "125.077520",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A24060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamin Patel, PSYD
• Shannon Patel
• Sheila Patel, BA
• Shetal M Patel, PH.D.
• Shina Dinesh Patel, D.D.S.
• Shreeti Hasmukh Patel, MD
• Shyam Ramesh Patel, D.O.
• Siri J Patel, M.D
• Stuti Patel
• Sunil K Patel, RPH

• Physical Medicine & Rehabilitation Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.