Individual provider Active NPI

Shirish Bavajibhai Patel, M.D

  • Internal Medicine Physician
  • Lakewood, CA
National Provider Identifier
1487765376
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A0040789 Issued in CA
Practice address
3650 E. South St
Suite 106
Lakewood, CA 90712-1532
Phone
(562) 925-7401
Fax
(105) 554-4045
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A0040789 CA Primary

Addresses

Primary practice location

3650 E. South St
Suite 106
Lakewood, CA 90712-1532

Mailing address

3650 South St Ste 106
Lakewood, CA 90712-1532
Phone (562) 925-7401

Other identifiers 1

IdentifierTypeStateIssuer
00A40789OtherCALICENSE

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
I20120206000108 CA Practitioner - Internal Medicine 6305003229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shirish B Patel MD IncGroup PAC ID 3779740691, 2 clinicians

Practice addresses (Care Compare)

3650 E S St
Suite 106
Lakewood, CA 90712-1532
Phone (562) 925-7401

Hospital & facility affiliations

  • Uci Health-Lakewood Hospital, Lakewood, CA, CCN 050581
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A0040789CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine Past Accepting new patients
CHLB, LLC Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1487765376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 106",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121532",
            "telephone_number": "562-925-7401",
            "fax_number": "310-554-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 E. SOUTH ST",
            "address_2": "SUITE 106",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121532",
            "telephone_number": "562-925-7401",
            "fax_number": "105-554-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIRISH",
        "middle_name": "BAVAJIBHAI",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A0040789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "00A40789",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.