Individual provider Active NPI

Nisha Rajnikant Patel, MD

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1356834873
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
174352 Issued in CA
Practice address
2130 National Ave
San Diego, CA 92113-2209
Phone
(619) 906-4623
NPI assigned
Jun 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 174352 CA Primary

Addresses

Primary practice location

2130 National Ave
San Diego, CA 92113-2209

Mailing address

1901 1St Ave
New York, NY 10029-7491
Phone (212) 423-6271

Other practice location 1

1901 1st Ave
New York, NY 10029-7491
Phone (212) 423-6271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 30, 2024 through Jan 30, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
174352CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1528502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1356834873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297491",
            "telephone_number": "212-423-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 NATIONAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132209",
            "telephone_number": "619-906-4623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100297491",
            "country_code": "US",
            "telephone_number": "212-423-6271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHA",
        "middle_name": "RAJNIKANT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-09",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "174352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.