Nisha Kantidev Patel-Venketsamy, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT2828 Issued in CA

Practice address

4626 Willow Rd
Suite 200
Pleasanton, CA 94588-8517

Phone

(925) 463-0470

Fax

(925) 463-0473

NPI assigned

May 26, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nisha Kantidev Patel Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Tri-Valley Orthopedic and Sports Medical Group Inc

  • Orthopaedic Surgery Physician
  • Pleasanton, CA
  • NPI 1184808156

  Occupational Therapist

  NPD (past)
• Tri-Valley Orthopedic and Sports Medical Group Inc

  • Orthopaedic Surgery Physician
  • San Ramon, CA
  • NPI 1801883731
  NPD (past)

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1376836155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 WILLOW RD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888517",
            "telephone_number": "925-463-0470",
            "fax_number": "925-463-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 WILLOW RD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888517",
            "telephone_number": "925-463-0470",
            "fax_number": "925-463-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL-VENKETSAMY",
        "first_name": "NISHA",
        "middle_name": "KANTIDEV",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT2828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OT2828",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01003597",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3701 Broadway",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NISHA",
            "last_name": "PATEL",
            "middle_name": "KANTIDEV",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Solomon Park, MD MPH
• Aleyna J Parker
• Danielle Parker
• Clare Parry, PPS
• Effat Pasha, REGISTERED NURSE
• Amitesh Patel, DDS
• Anjali Patel
• Bijal Maulin Patel, M.D.
• Divian Narendra Patel, DDS
• Jignesh Ranjit Patel, R.PH

• Occupational Therapist in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.