Individual provider Active NPI

Radha Patel, NP

  • Acute Care Nurse Practitioner
  • Buena Park, CA
National Provider Identifier
1326793910
Registry record updated Feb 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95019848 Issued in CA
Practice address
8219 Santa Inez Way
Buena Park, CA 90620-3158
Phone
(714) 422-9529
NPI assigned
Feb 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95019848 CA Primary

Addresses

Primary practice location

8219 Santa Inez Way
Buena Park, CA 90620-3158

Mailing address

8219 Santa Inez Way
Buena Park, CA 90620-3158
Phone (714) 422-9529

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226002781 CA Practitioner - Nurse Practitioner 4688194293 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Prohealth Partners a Medical Group Inc Past Accepting new patients

Locations

435 Arden Ave
Ste 340
Glendale, CA 91203
Phone (818) 246-7245

3650 South St
Ste 212
Lakewood, CA 90712
Phone (562) 272-7630

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1644710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1326793910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8219 SANTA INEZ WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203158",
            "telephone_number": "714-422-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8219 SANTA INEZ WAY",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203158",
            "telephone_number": "714-422-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "RADHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-13",
        "last_updated": "2022-02-13",
        "certification_date": "2021-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95019848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.