Individual provider Active NPI

Nima Patel, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Burlingame, CA
National Provider Identifier
1376728253
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
19204 Issued in CA
Practice address
1828 El Camino Real
Ste 611
Burlingame, CA 94010-3103
Phone
(650) 696-2431
Fax
(650) 696-3659
NPI assigned
Jan 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 19204 CA Primary

Addresses

Primary practice location

1828 El Camino Real
Ste 611
Burlingame, CA 94010-3103

Mailing address

195 London CT
San Bruno, CA 94066-3905
Phone (650) 888-9820

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
I20100129000355 CA Practitioner - Physician Assistant 7416090410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Heart and Vascular AssociatesGroup PAC ID 5890125157, 9 clinicians

Practice addresses (Care Compare)

1850 El Camino Real
Suite 200
Burlingame, CA 94010-3102
Phone (650) 697-2431

Hospital & facility affiliations

  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

Merit-based Incentive Payment System (MIPS)

Final score
22.73 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19204CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Hospital and Clinics Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: npatel42218@hisp.ehr.sutterhealth.org
  • Direct secure messaging: npatel@trimed.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1376728253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 LONDON CT",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663905",
            "telephone_number": "650-888-9820",
            "fax_number": "650-876-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 EL CAMINO REAL",
            "address_2": "STE 611",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103103",
            "telephone_number": "650-696-2431",
            "fax_number": "650-696-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIMA",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "19204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.