Individual provider Active NPI

Manisha Patel, PA-C

  • Medical Physician Assistant
  • Claremont, CA
National Provider Identifier
1639407224
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
20690 Issued in CA
Practice address
1601 Monte Vista Ave Ste 100
Claremont, CA 91711-6601
Phone
(909) 630-7938
Fax
(909) 469-2118
NPI assigned
Nov 19, 2009
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 20690 CA Primary

Addresses

Primary practice location

1601 Monte Vista Ave Ste 100
Claremont, CA 91711-6601

Mailing address

1601 Monte Vista Ave Ste 100
Claremont, CA 91711-6601
Phone (909) 630-7938

Other identifiers 3

IdentifierTypeStateIssuer
EK392Z SOUTHERNOtherCAPTAN
1639407224MedicaidCA
EK392Y NORTHOtherCAPTAN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000322 CA Practitioner - Physician Assistant 0749460038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1601 Monte Vista Ave
Suite 100
Claremont, CA 91711-6601
Phone (909) 630-7893

1770 N Orange Grove Ave
Suite 101
Pomona, CA 91767-3027
Phone (909) 469-9494

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.43 of 100Reported as group
Quality
13.12
Promoting interoperability
100
Improvement activities
0
Cost
74.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20690CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Medicine Associates, Inc CurrentSince Nov 22, 2010 Accepting new patients
Premier Family Medicine Associates, Inc Past Accepting new patients

Locations

2140 Grand Ave
Ste 125
Chino Hills, CA 91709
Phone (909) 630-7875

3110 Chino Ave
Ste 150A
Chino Hills, CA 91709
Phone (909) 630-7490

1601 Monte Vista Ave
Ste 100
Claremont, CA 91711
Phone (909) 630-7938

1770 N Orange Grove Ave
Ste 101
Pomona, CA 91767

Organizations & group practices 3

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": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1639407224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MONTE VISTA AVE STE 100",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917116601",
            "telephone_number": "909-630-7938",
            "fax_number": "909-469-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MONTE VISTA AVE STE 100",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917116601",
            "telephone_number": "909-630-7938",
            "fax_number": "909-469-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MANISHA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "20690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "EK392Z SOUTHERN",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639407224",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "EK392Y NORTH",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

Verify at the official NPI Registry.