Individual provider Active NPI

Shiv Pravin Patel

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1306426093
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A195003 Issued in CA
Practice address
1131 Wilshire Blvd Ste 300
Santa Monica, CA 90401-2066
Phone
(310) 395-5588
Fax
(310) 395-6313
NPI assigned
Apr 8, 2021
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL86021 SC
Family Medicine Physician 207Q00000X A195003 CA Primary

Addresses

Primary practice location

1131 Wilshire Blvd Ste 300
Santa Monica, CA 90401-2066

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-5138

Other practice location 1

877 W Faris Rd
Greenville, SC 29605-4289
Phone (864) 455-7800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807003727 CA Practitioner - Family Practice 3971906512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1131 Wilshire Blvd
Suite 300
Santa Monica, CA 90401-2066
Phone (310) 395-5588

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

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
A195003CAMDFamily Medicine Physician
LL86021SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
The Regents of the University of California CurrentSince Sep 1, 2024 Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

1131 Wilshire Blvd
Ste 300
Santa Monica, CA 90401
Phone (310) 395-5588

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

Organizations & group practices 3

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 3

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1306426093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 WILSHIRE BLVD STE 300",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012066",
            "telephone_number": "310-395-5588",
            "fax_number": "310-395-6313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 W Faris Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054289",
            "country_code": "US",
            "telephone_number": "864-455-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIV",
        "middle_name": "PRAVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL86021",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A195003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.