Individual provider Active NPI

Jeenaben Patel

  • Registered Nurse
  • San Leandro, CA
National Provider Identifier
1215329172
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95142808 Issued in CA
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, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103000253 CA Practitioner - Nurse Practitioner 0042709685 Reassigns benefits to 1 organization

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
Pine Park Health, IncGroup PAC ID 0345670527, 21 clinicians

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

LicenseStateTypeSpecialty
95142808CAMDRegistered Nurse
285896CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Park Health, Inc CurrentSince Nov 1, 2025 Accepting new patients
Integrated Pain Management Medical Group, Inc. PastSince Oct 27, 2024 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

  • FHIR API: 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.

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.