Individual provider Active NPI

Punit Mayankkumar Patel, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Santa Cruz, CA
National Provider Identifier
1629500608
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20A18911 Issued in CA
Practice address
1595 Soquel Dr Ste 140
Santa Cruz, CA 95065-1717
Phone
(831) 462-4444
Fax
(831) 462-4488
NPI assigned
Mar 30, 2017
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 20A18911 CA Primary

Addresses

Primary practice location

1595 Soquel Dr Ste 140
Santa Cruz, CA 95065-1717

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

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
I20210831003399 CA Practitioner - Physical Medicine and Rehabilitation 6103160650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Western University of Health Sciences College of Dental Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast RehabilitationGroup PAC ID 9931509882, 8 clinicians

Practice addresses (Care Compare)

2181 Citracado Pkwy
Escondido, CA 92029-4159
Phone (442) 277-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18911CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Rehabilitation Physical Medicine & Rehabilitation CurrentSince Jul 1, 2023 Accepting new patients
Palomar Health Past Accepting new patients

Locations

2181 Citracado Pkwy
Escondido, CA 92029
Phone (442) 277-6100

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

1822 E Route 66
Ste A
Glendora, CA 91740
Phone (626) 665-5468

5319 University Dr
Irvine, CA 92612
Phone (949) 345-0945

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

15720 Bernardo Center Dr
San Diego, CA 92127
Phone (858) 500-2693

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1629500608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DR STE 140",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651717",
            "telephone_number": "831-462-4444",
            "fax_number": "831-462-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PUNIT",
        "middle_name": "MAYANKKUMAR",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A18911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.