Individual provider Active NPI

Sujay Pathak

  • Hospitalist Physician
  • Palm Springs, CA
National Provider Identifier
1679192272
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
20A21217 Issued in CA
Practice address
1100 N Palm Canyon Dr Ste 109
Palm Springs, CA 92262-4418
Phone
(760) 327-3846
NPI assigned
Apr 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 20A21217 CA Primary

Addresses

Primary practice location

1100 N Palm Canyon Dr Ste 109
Palm Springs, CA 92262-4418

Mailing address

1100 N Palm Canyon Dr Ste 109
Palm Springs, CA 92262-4418

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
I20230905003223 CA Practitioner - Internal Medicine 9739542952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Faculty Medical Group IncGroup PAC ID 9436253515, 76 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 656-1500

Hospital & facility affiliations

  • Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

Merit-based Incentive Payment System (MIPS)

Final score
97.34 of 100Reported as group
Quality
84.11
Promoting interoperability
96
Improvement activities
40
Cost
77.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21217CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Faculty Medical Group Inc CurrentSince Aug 1, 2023 Accepting new patients

Locations

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

Interoperability endpoints

  • Direct secure messaging: spathak371976@direct.llu.edu

Organizations & group practices 1

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 1

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1679192272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR STE 109",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR STE 109",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624418",
            "telephone_number": "760-327-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "SUJAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A21217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.