Individual provider Active NPI

Amy Patel, M.D.

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1417480930
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
74335 Issued in CT
Practice address
747 52ND St
Oakland, CA 94609-1809
Phone
(510) 428-3331
Fax
(510) 601-3979
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A157263 CA
Neonatal-Perinatal Medicine Physician 2080N0001X A157263 CA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 74335 CT Primary

Addresses

Primary practice location

747 52ND St
Oakland, CA 94609-1809

Mailing address

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230607003444 CT Practitioner - Pediatric Medicine 9638407034 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157263CAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Dec 13, 2025 Accepting new patients
Greenwich Hospital CurrentSince Nov 1, 2025 Accepting new patients
Greenwich Hospital CurrentSince Nov 1, 2025 Accepting new patients
Yale University CurrentSince Dec 13, 2025 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Jun 1, 2023 Accepting new patients
Connecticut Children'S Specialty Group, Inc. Pediatrics CurrentSince Jun 1, 2023 Accepting new patients
Stamford Health Medical Group Inc Neonatal-Perinatal Medicine CurrentSince Feb 5, 2024 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

500 W Putnam Ave
Greenwich, CT 06830
Phone (203) 869-2510

10 Columbus Blvd
Fl 4
Hartford, CT 06106
Phone (860) 837-5560

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

5 High Ridge Park
Ste 103
Stamford, CT 06905
Phone (203) 276-4644

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

Interoperability endpoints

  • Direct secure messaging: apatel78708@valleychildrens-prd.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

Organizations & group practices 7

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1417480930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3331",
            "fax_number": "510-601-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3331",
            "fax_number": "510-601-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157263",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A157263",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "74335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.