Individual provider Active NPI

Shivangi Patel, MD

  • Family Medicine Physician
  • Troy, NY
National Provider Identifier
1740843317
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
318540 Issued in NY
Practice address
79 Vandenburgh Ave
Troy, NY 12180-6024
Phone
(518) 271-0063
NPI assigned
Apr 18, 2019
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 318540 NY Primary

Addresses

Primary practice location

79 Vandenburgh Ave
Troy, NY 12180-6024

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

6 Healthy Way
Ellenville, NY 12428-5612
Phone (845) 647-4500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221025001380 NY Practitioner - Family Practice 6002282563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

79 Vandenburgh Ave
Troy, NY 12180-6024
Phone (518) 286-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318540NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Nov 28, 2022 Accepting new patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Nov 28, 2022 Accepting new patients
Samaritan Hospital of Troy, New York Past Accepting new patients

Locations

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

79 Vandenburgh Ave
Troy, NY 12180
Phone (518) 269-4690

Interoperability endpoints

  • Direct secure messaging: spatel2307871@direct.trinity-health.org

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 3

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1740843317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 VANDENBURGH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806024",
            "telephone_number": "518-271-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Ellenville",
            "state": "NY",
            "postal_code": "124285612",
            "country_code": "US",
            "telephone_number": "845-647-4500",
            "fax_number": "845-647-7632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVANGI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "318540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "79 Vandenburgh Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121806024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.