Shivani Patel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106944 Issued in FL

Practice address

105 S Banana River Blvd FL 2
Cocoa Beach, FL 32931-5041

Phone

(321) 200-0346

NPI assigned

Jul 23, 2013

Last updated

Feb 27, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shadetree Dermatology LLCGroup PAC ID 8628511227, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.79 of 100Reported as apm

Quality

86.5

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Shadetree Dermatology LLC

  • Dermatology Physician
  • Cocoa Beach, FL
  • NPI 1366297376
  Medicare reassignment Care Compare group
• Center for Skin Cancer Surgery, Inc.

  • MOHS-Micrographic Surgery Physician
  • Melbourne, FL
  • NPI 1871900233
  NPD (past)

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1215379904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S BANANA RIVER BLVD FL 2",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329315041",
            "telephone_number": "321-200-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BANANA RIVER BLVD FL 2",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329315041",
            "telephone_number": "321-200-0346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "389 Commerce Pkwy Ste 160",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329554202",
            "country_code": "US",
            "telephone_number": "321-200-0346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVANI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "HP529Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL RR MEDICARE",
            "identifier": "P01385335",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William H. Oyler, M.S, M.A. 7370
• Ann Ruth Pariente, L.AC, DIPL. O.M.
• Bhupendra V Patel, RPH
• Hetal S Patel
• Pramesh Patel, M.D.
• Robert H Paxson, M.D.
• Peace Club Inc. (Peace Club)
• Pediatrics in Brevard, P.a.
• Pediatrics in Brevard, P.a.
• Brittany Lauren Peeler, DNP

• Physician Assistant in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.