Individual provider Active NPI

Mamataben Suraj Patel, FNP

  • Nurse Practitioner
  • Pleasanton, CA
National Provider Identifier
1710512124
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95013048 Issued in CA
Practice address
4256 Hacienda Dr Ste 100
Pleasanton, CA 94588-8595
Phone
(925) 264-6510
NPI assigned
Mar 5, 2020
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95013048 CA Primary

Addresses

Primary practice location

4256 Hacienda Dr Ste 100
Pleasanton, CA 94588-8595

Mailing address

4256 Hacienda Dr Ste 100
Pleasanton, CA 94588-8595
Phone (925) 264-6510

Other names 1

  • Mamataben Bhanderi Former name

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
I20200424002615 CA Practitioner - Nurse Practitioner 0042640476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

11030 Bollinger Canyon Rd
Suite 250
San Ramon, CA 94582-4874
Phone (925) 373-8000

4256 Hacienda Dr
Suite 100200
Pleasanton, CA 94588-8595
Phone (925) 264-6510

4725 1St St
Suite 100
Pleasanton, CA 94566-7366
Phone (925) 462-7060

5568 Gibraltar Dr
Pleasanton, CA 94588-8544
Phone (888) 924-1036

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95013048CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Alliance CurrentSince Apr 1, 2020 Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

5565 W Las Positas Blvd
Ste 260
Pleasanton, CA 94588
Phone (925) 416-5470

Interoperability endpoints

  • Direct secure messaging: mpatel263830@direct.stanfordhealthcare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1710512124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4256 HACIENDA DR STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888595",
            "telephone_number": "925-264-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4256 HACIENDA DR STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888595",
            "telephone_number": "925-264-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MAMATABEN",
        "middle_name": "SURAJ",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAMATABEN",
            "last_name": "BHANDERI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.