Individual provider Active NPI

Shalini R. Patel, MD

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1396900486
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME110956 Issued in FL
Practice address
51 Pennsylvania St
Orlando, FL 32806-2937
Phone
(321) 843-3220
Fax
(321) 843-3210
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2080A000000X CT
Pediatrics Physician 208000000X ME110956 FL Primary

Addresses

Primary practice location

51 Pennsylvania St
Orlando, FL 32806-2937

Mailing address

51 Pennsylvania St
Orlando, FL 32806-2937
Phone (321) 843-3220

Other identifiers 2

IdentifierTypeStateIssuer
004121100MedicaidFL
14H85OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111103000509 FL Practitioner - Obstetrics/GynecologyPractitioner - Pediatric Medicine 9335312511 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2080A000000XCTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince Jul 23, 2018 Accepting new patients
Phoenix Pediatrics of Broward LLC Pediatrics Current Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157

Interoperability endpoints

  • Direct secure messaging: spatel342991@orlandohealth.medalliesdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1396900486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PENNSYLVANIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062937",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 PENNSYLVANIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062937",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHALINI",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "2080A000000X",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME110956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004121100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14H85",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.