Individual provider Active NPI

Disha N Patel

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1124818836
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1215534 Issued in TX
Practice address
333 N Santa Rosa
San Antonio, TX 78207-3108
Phone
(210) 704-8829
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN2390986 MA
Pediatric Nurse Practitioner 363LP0200X 1215534 TX Primary

Addresses

Primary practice location

333 N Santa Rosa
San Antonio, TX 78207-3108

Mailing address

7960 Riviera CT
Beaumont, TX 77707-5477
Phone (409) 651-4067

Other practice location 1

7960 Riviera Ct
Beaumont, TX 77707-5477
Phone (409) 651-4067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260221000306 TX Practitioner - Nurse Practitioner 9335620905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Baylor PLZ
2Gr900
Houston, TX 77030-3498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2390986MAMDPediatric Registered Nurse
1215534TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Feb 2, 2026 Accepting new patients

Locations

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1124818836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 RIVIERA CT",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777075477",
            "telephone_number": "409-651-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-8829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7960 Riviera Ct",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777075477",
            "country_code": "US",
            "telephone_number": "409-651-4067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DISHA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2390986",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1215534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.