Individual provider Active NPI

Shatishkumar Y Patel, M.D.

  • Nephrology Physician
  • Houston, TX
National Provider Identifier
1366450579
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
L0495 Issued in TX
Practice address
8200 Wednesbury LN
Suite 295
Houston, TX 77074-2925
Phone
(713) 533-0995
Fax
(713) 772-5475
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X L0495 TX Primary

Addresses

Primary practice location

8200 Wednesbury LN
Suite 295
Houston, TX 77074-2925

Mailing address

8200 Wednesbury LN
Suite 295
Houston, TX 77074-2925
Phone (713) 533-0995

Other identifiers 3

IdentifierTypeStateIssuer
0039KJOtherTXBC/BS
148933802MedicaidTX
DA5819OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120918000163 TX Practitioner - Internal MedicinePractitioner - Nephrology 7719870088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shatishkumar Y Patel, MD, PA Nephrology CurrentSince Aug 7, 2012 Accepting new patients
Atrium Medical Center, LP Past Accepting new patients
Renalpartners Foundations Nephrology Past Accepting new patients
Beechnut Dialysis Center LLC PastSince Feb 3, 2004 Accepting new patients

Locations

8200 Wednesbury Ln
Ste 290
Houston, TX 77074
Phone (713) 533-0995

7777 Southwest Fwy
Ste 748
Houston, TX 77074
Phone (713) 533-0995

8200 Wednesbury Ln
Ste 295
Houston, TX 77074
Phone (713) 533-0995

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Atrium Medical CenterStafford, TX, CCN 452114 Hospital 5% Or Greater Indirect Ownership Interest (91.75%)
W-2 Managing Employee
May 7, 2021
Nov 9, 2005
Atrium Medical CenterStafford, TX, CCN 45SB14 Hospital 5% Or Greater Indirect Ownership Interest (91.75%)
W-2 Managing Employee
May 7, 2021
Nov 9, 2005

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1366450579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN",
            "address_2": "SUITE 295",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742925",
            "telephone_number": "713-533-0995",
            "fax_number": "713-772-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN",
            "address_2": "SUITE 295",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742925",
            "telephone_number": "713-533-0995",
            "fax_number": "713-772-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHATISHKUMAR",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "L0495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0039KJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148933802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA5819",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.