NPIMap

Individual provider Active NPI

Pranjalkumar H Patel, M.D.

  • Family Medicine Physician
  • Tracy, CA
National Provider Identifier
1225233133
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A116600 Issued in CA
Practice address
1530 Bessie Ave
Suite 105
Tracy, CA 95376-3080
Phone
(209) 836-3967
Fax
(209) 836-0626
NPI assigned
Jun 19, 2007
Last updated
Jun 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A116600 CA Primary

Addresses

Primary practice location

1530 Bessie Ave
Suite 105
Tracy, CA 95376-3080

Mailing address

1530 Bessie Ave
Suite 105
Tracy, CA 95376-3080
Phone (209) 836-3967

Other identifiers 1

IdentifierTypeStateIssuer
200924520MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000054 CA Practitioner - Family Practice 4688741283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premiercare Physicians a California General PartnershipGroup PAC ID 5799113031, 5 clinicians

Practice addresses (Care Compare)

1470 Bessie Ave
Tracy, CA 95376-3417
Phone (209) 883-0525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A116600CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premiercare Physicians a California General Partnership Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients
Porter Health Services Family Medicine Past Accepting new patients
Evergreen at Tracy, L.L.C. Past Accepting new patients
Porter Physician Services LLC Family Medicine Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Locations

1144 Norman Dr
Ste 204
Manteca, CA 95336
Phone (209) 665-4252

531 W Yosemite Ave
Manteca, CA 95337
Phone (209) 833-0525

1470 Bessie Ave
Tracy, CA 95376
Phone (209) 833-0525

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ppatel14038@hpmg.direct-ci.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Park Post-AcuteTracy, CA, CCN 555245 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2021
Jan 1, 2021
Amore Hospice IncOakland, CA, CCN B21732 Hospice 5% Or Greater Indirect Ownership Interest (7.5%) Sep 28, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Amore Hospice, Inc.
    • Community Based Hospice Care Agency
    • Pleasanton, CA
    • NPI 1750895496

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Atba, LLC

    dba North Park Post-Acute

    • Skilled Nursing Facility
    • Tracy, CA
    • NPI 1649876541

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 7

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 9

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1225233133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 BESSIE AVE",
            "address_2": "SUITE 105",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763080",
            "telephone_number": "209-836-3967",
            "fax_number": "209-836-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BESSIE AVE",
            "address_2": "SUITE 105",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763080",
            "telephone_number": "209-836-3967",
            "fax_number": "209-836-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRANJALKUMAR",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A116600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200924520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.