Individual provider Active NPI

Payal Amin Patel, M.D.

  • Pediatric Cardiology Physician
  • Riverside, CA
National Provider Identifier
1578762290
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A107507 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2658
Phone
(951) 782-3683
Fax
(951) 784-3256
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X A107507 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2658

Mailing address

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 782-3683

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ31887ZOtherCASITE PTAN NUMBER

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
I20140122001838 CA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 8921236886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
George Washington University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107507CAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc CurrentSince Aug 1, 2013 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients

Locations

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

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.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1578762290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3683",
            "fax_number": "951-784-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-3683",
            "fax_number": "951-784-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PAYAL",
        "middle_name": "AMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A107507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE PTAN NUMBER",
            "identifier": "ZZZ31887Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.