Individual provider Active NPI

Heraj Patel, DPM

  • Foot & Ankle Surgery Podiatrist
  • Thousand Oaks, CA
National Provider Identifier
1225380462
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5139 Issued in CA
Practice address
3095 Old Conejo Rd Ste 100
Thousand Oaks, CA 91320-2130
Phone
(805) 273-1415
NPI assigned
Oct 12, 2012
Last updated
Dec 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E5139 CA Primary

Addresses

Primary practice location

3095 Old Conejo Rd Ste 100
Thousand Oaks, CA 91320-2130

Mailing address

3095 Old Conejo Rd Ste 100
Thousand Oaks, CA 91320-2130

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222000042 CA Practitioner - Podiatry 8820304710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Foot and Ankle IncGroup PAC ID 2466713896, 3 clinicians

Practice addresses (Care Compare)

3095 Old Conejo Rd
Suite 100
Newbury Park, CA 91320-2130
Phone (805) 273-1415

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76 of 100Reported as group
Quality
52
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue30
Removal of skin lesions1-10
Removal of nail tissue709
Removal or shaving of skin growth675
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5139CAMDFoot & Ankle Surgery Podiatrist
5139CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peripheral Vascular Institute, Inc. a Podiatry Corp CurrentSince Aug 4, 2020 Accepting new patients
Performance Foot & Ankle Inc Foot & Ankle Surgery CurrentSince Jan 13, 2018 Accepting new patients

Locations

2100 Solar Dr
Ste 103
Oxnard, CA 93036
Phone (805) 293-6436

18375 Ventura Blvd
Tarzana, CA 91356
Phone (818) 422-5322

3095 Old Conejo Rd
Ste 100
Thousand Oaks, CA 91320
Phone (805) 273-1415

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 1

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": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1225380462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913202130",
            "telephone_number": "805-273-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HERAJ",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.