Active NPI
Karishma Patel, M.D.
- Child & Adolescent Psychiatry Physician
- San Diego, CA
National Provider Identifier
1740644111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A161454
- Practice address
- 3020 Childrens Way
San Diego, CA 92123-4223 - Phone
- (858) 576-1700
- NPI assigned
- Apr 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A161454 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | A161454 | CA | Primary |
Addresses
Primary practice location
3020 Childrens Way
San Diego, CA 92123-4223
Mailing address
3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A161454 | CA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Russell Bruce Hubbard MD Inc | Psychiatry | Current | Accepting new patients |
Locations
1565 Hotel Cir S
Ste 200
San Diego, CA 92108
Phone (619) 295-8005
1565 Hotel Cir S
Ste 310
San Diego, CA 92108
Phone (619) 295-8005
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
- kpatel257304@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.
-
- Psychiatry Physician
- San Diego, CA
- NPI 1053430744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1740644111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY # MC5003",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-309-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-576-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "KARISHMA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-11",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A161454",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A161454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.