Individual provider Active NPI

Hetal B Patel, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1447221767
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036125902 Issued in IL
Practice address
12526 High Bluff Dr Ste 300
San Diego, CA 92130-2067
Phone
(760) 655-3902
NPI assigned
Jan 27, 2006
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A130735 CA
Emergency Medicine Physician 207P00000X 036125902 IL Primary

Addresses

Primary practice location

12526 High Bluff Dr Ste 300
San Diego, CA 92130-2067

Mailing address

12526 High Bluff Dr Ste 300
San Diego, CA 92130-2067
Phone (760) 655-3902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140916002551 CA Practitioner - Emergency Medicine 7113174285 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130735CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Joint and Spine Medical Center Inc. CurrentSince May 23, 2017 Accepting new patients
Emergency Medicine Group of Encinitas, Inc Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Advanced Joint and Spine Medical Center Inc. Emergency Medicine CurrentSince Feb 3, 2019 Accepting new patients
Emergency Medicine Physicians of Iredell County, PLLC Emergency Medicine Past Accepting new patients
April Lopez Chiropractic. a Professional Corporation Past Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Emergency Medicine Past Accepting new patients

Locations

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

2029 W Orangewood Ave
Ste A
Orange, CA 92868
Phone (714) 385-9088

5455 Garden Grove Blvd
Ste 100
Westminster, CA 92683
Phone (714) 362-7942

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1447221767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12526 HIGH BLUFF DR STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302067",
            "telephone_number": "760-655-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12526 HIGH BLUFF DR STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302067",
            "telephone_number": "760-655-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "HETAL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A130735",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036125902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.