Pooja Patel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

59398 Issued in CA

Practice address

10 Santa Rosa St Unit 201
San Luis Obispo, CA 93405-5826

Phone

(805) 544-7246

NPI assigned

Jun 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pooja.wall.p1@direct.ppcacentralcoast.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pain Management Specialists Medical Group

  • Specialist
  • San Luis Obispo, CA
  • NPI 1265435416
  Medicare reassignment
• Pain Management Specialists Medical Group

  • Specialist
  • Santa Maria, CA
  • NPI 1679857510
  NPD
• Planned Parenthood California Central Coast

  • Community Health Clinic/Center
  • Thousand Oaks, CA
  • NPI 1619994191
  NPD (past)

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625961600000",
    "number": "1255908265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SANTA ROSA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SANTA ROSA ST UNIT 201",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055826",
            "telephone_number": "805-544-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POOJA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Trevor Passon
• Autumn Patchett
• Christopher John Pate
• Jashvant Gangaram Patel, M.D.
• Nikita Mohan Patel, M.D.
• Shilpa Patel
• Juana Patlan Mendez
• Taylor Marie Patten, BCBA
• Stephanie Patterson
• Paul D. Wetzel, M.D. Inc

• Physician Assistant in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.