NPIMap

Individual provider Active NPI

Samir Patel, MD

  • Nephrology Physician
  • Garden Grove, CA
National Provider Identifier
1427519552
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
177071 Issued in CA
Practice address
12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916
Phone
(714) 636-2890
NPI assigned
Mar 29, 2019
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 177071 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916

Mailing address

12665 Garden Grove Blvd Ste 211
Garden Grove, CA 92843-1916
Phone (714) 636-2890

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
I20230418000123 CA Practitioner - NephrologyPractitioner - Internal Medicine 8921473307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Kidney Consultants IncGroup PAC ID 6103811286, 21 clinicians

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 211
Garden Grove, CA 92843-1916
Phone (714) 636-2890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177071CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Kidney Consultants Inc. Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group Single Specialty CurrentSince Feb 18, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Feb 18, 2023 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

100 E Valencia Mesa Dr
Ste 100
Fullerton, CA 92835
Phone (714) 525-4185

12665 Garden Grove Blvd
Ste 211
Garden Grove, CA 92843
Phone (714) 636-2890

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

1310 W Stewart Dr
Ste 210
Orange, CA 92868
Phone (714) 288-9229

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21072/brand/1/csg/1/fhir/r4
  • Direct secure messaging: samir.patel.1@21072.direct.athenahealth.com
  • Direct secure messaging: spatel846316@direct.memorialcare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1427519552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 211",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431916",
            "telephone_number": "714-636-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 211",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431916",
            "telephone_number": "714-636-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAMIR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "177071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.