NPIMap

Organization Active NPI

Platinum Digestive Health

  • Gastroenterology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1629537352
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
PLATINUM DIGESTIVE HEALTH
Practice address
9481 Pittsburgh Ave Ste 200
Rancho Cucamonga, CA 91730-9021
Phone
(909) 655-0300
Fax
(909) 655-1161
NPI assigned
Mar 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2023

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

Authorized official

Name
Bhaveshkumar J Patel
Title
MD
Phone
(909) 556-5988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

9481 Pittsburgh Ave Ste 200
Rancho Cucamonga, CA 91730-9021

Mailing address

9481 Pittsburgh Ave Ste 200
Rancho Cucamonga, CA 91730-9021
Phone (909) 655-0300

Other practice location 1

250 W Bonita Ave Ste 200
Pomona, CA 91767-1891
Phone (909) 868-6800

Other identifiers 1

IdentifierTypeStateIssuer
1629537352MedicaidCA

Other names 1

  • PLATINUM DIGESTIVE HEALTH Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL p4300.cphy_pr.cernerasp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190706000062 CA Part B Supplier - Clinic/Group Practice 9931434495 Receives reassigned benefits from 10 practitioners
Practice locations: Pomona, CA; Rancho Cucamonga, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2295343Platinum Digestive Health9481 Pittsburgh Ave, Ste 200, Rancho Cucamonga, CA 91730ComplianceMay 13, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702684800000",
    "number": "1629537352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9481 PITTSBURGH AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309021",
            "telephone_number": "909-655-0300",
            "fax_number": "909-655-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9481 PITTSBURGH AVE STE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309021",
            "telephone_number": "909-655-0300",
            "fax_number": "909-655-1161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 W Bonita Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671891",
            "country_code": "US",
            "telephone_number": "909-868-6800",
            "fax_number": "909-392-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PLATINUM DIGESTIVE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-12",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BHAVESHKUMAR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "909-556-5988"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629537352",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "p4300.cphy_pr.cernerasp.com",
            "affiliation": "N",
            "endpointDescription": "Cerner",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9481 Pittsburgh Ave Ste 200",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917309021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PLATINUM DIGESTIVE HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PLATINUM DIGESTIVE HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.