NPIMap

Individual provider Active NPI

Shyam P Patel, M.D.

  • Internal Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1194104703
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
61736 Issued in AZ
Practice address
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone
(909) 881-4520
NPI assigned
May 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A158028 CA
Internal Medicine Physician 207R00000X 61736 AZ Primary

Addresses

Primary practice location

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Mailing address

3115 S Price Rd
Chandler, AZ 85248-3544
Phone (888) 488-7640

Other practice location 1

3115 S Price Rd
Chandler, AZ 85248-3544
Phone (888) 488-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190212003184 CA Practitioner - Internal Medicine 5294073524 Reassigns benefits to 1 organization
I20201013002304 AZ Practitioner - Internal Medicine 5294073524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aia Hospitalists LLCGroup PAC ID 3375583636, 51 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 105
Phoenix, AZ 85048-7693
Phone (480) 961-2303

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61736AZMDInternal Medicine Physician
A158028CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aia Hospitalists LLC Internal Medicine CurrentSince Jan 30, 2024 Accepting new patients
Pioneer Hospitalists, PLLC Internal Medicine CurrentSince Sep 16, 2020 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

3100 W Ray Rd
Ste 201
Chandler, AZ 85226
Phone (269) 312-1446

3115 S Price Rd
Chandler, AZ 85248
Phone (480) 855-4011

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

4530 E Muirwood Dr
Ste 105
Phoenix, AZ 85048
Phone (480) 961-2303

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Organizations & group practices 4

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1194104703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 S PRICE RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852483544",
            "telephone_number": "888-488-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-881-4520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3115 S Price Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852483544",
            "country_code": "US",
            "telephone_number": "888-488-7640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHYAM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-28",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A158028",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "61736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.