Active NPI
Jeenaben Patel
- Registered Nurse
- San Leandro, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95142808
- Practice address
- 2410 Merced St
San Leandro, CA 94577-4211 - Phone
- (510) 278-2700
- Fax
- (510) 343-2851
- NPI assigned
- Mar 2, 2015
- Last updated
- Oct 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 285896 | CA | |
| Registered Nurse | 163W00000X | 95142808 | CA | Primary |
Addresses
Primary practice location
2410 Merced St
San Leandro, CA 94577-4211
Mailing address
PO Box 888584
Los Angeles, CA 90088-8584
Phone (925) 691-9806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Berkeley, CA 94710
Phone (510) 929-1400
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95142808 | CA | MD | Registered Nurse |
| 285896 | CA | MD | Licensed Vocational Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Park Health, Inc | Current | Accepting new patients | |
| Integrated Pain Management Medical Group, Inc. | Past | Accepting new patients |
Locations
1901 4th St
Ste 201
Berkeley, CA 94710
Phone (469) 401-8820
22445 Cupertino Rd
Cupertino, CA 95014
Phone (408) 253-4300
3850 Walnut Ave
Fremont, CA 94538
Phone (341) 206-8344
16977 Healdsburg Ave
Healdsburg, CA 95448
1144 65th St
Ste F
Oakland, CA 94608
Phone (510) 919-1400
1444 McAllister St
San Francisco, CA 94115
Phone (415) 305-4002
Interoperability endpoints
- https://api.platform.athenahealth.com/21048/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Berkeley, CA
- NPI 1346879848
-
dba Boomerang Healthcare
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Walnut Creek, CA
- NPI 1922198779
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- San Ramon, CA
- NPI 1972559961
-
- Home Health Agency
- Concord, CA
- NPI 1538411632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1215329172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 888584",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900888584",
"telephone_number": "925-691-9806",
"fax_number": "925-691-9807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 MERCED ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774211",
"telephone_number": "510-278-2700",
"fax_number": "510-343-2851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JEENABEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-02",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "285896",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95142808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.