NPIMap

Individual provider Active NPI

Shruti Pravinkumar Patel, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1376937656
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A146173 Issued in CA
Practice address
4150 V St # 1110
Sacramento, CA 95817-1460
Phone
(916) 734-2737
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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
Gastroenterology Physician 207RG0100X A146173 CA Primary

Addresses

Primary practice location

4150 V St # 1110
Sacramento, CA 95817-1460

Mailing address

11823 Galvani St
Las Vegas, NV 89183-5530

Other practice location 1

500 Doyle Park Dr Ste 205
Santa Rosa, CA 95405-4559
Phone (707) 303-8350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618000208 CA Practitioner - Internal MedicinePractitioner - Gastroenterology 0143581405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
University of Nevada School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

500 Doyle Park Dr
Suite 205
Santa Rosa, CA 95405-4559
Phone (707) 303-8349

Hospital & facility affiliations

  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy130
Upper gastrointestinal (GI) endoscopy for acid reflux232

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 1, 2022 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Sep 1, 2022 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

500 Doyle Park Dr
Ste 205
Santa Rosa, CA 95405
Phone (707) 303-8350

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: spatel2534302@oc.providencedirect.org

Organizations & group practices 5

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 4

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": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1376937656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11823 GALVANI ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST # 1110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Doyle Park Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954054559",
            "country_code": "US",
            "telephone_number": "707-303-8350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHRUTI",
        "middle_name": "PRAVINKUMAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A146173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.