Individual provider Active NPI

Khushali Patel, PA-C

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1740922251
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65412 Issued in CA
Practice address
1691 The Alameda
San Jose, CA 95126-2203
Phone
(408) 287-7526
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65412 CA Primary

Addresses

Primary practice location

1691 The Alameda
San Jose, CA 95126-2203

Mailing address

1691 The Alameda
San Jose, CA 95126-2203

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
I20250123002459 CA Practitioner - Physician Assistant 3870022684 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65412CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte Inc. CurrentSince Jan 6, 2025 Accepting new patients
Planned Parenthood Mar Monte, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Planned Parenthood Mar Monte, Inc Past Accepting new patients

Locations

2500 California St
Ste A
Mountain View, CA 94040
Phone (408) 795-3600

2907 El Camino Real
Redwood City, CA 94061
Phone (650) 235-7940

5440 Thornwood Dr
Ste G
San Jose, CA 95123
Phone (408) 281-9777

1691 The Alameda
San Jose, CA 95126
Phone (408) 287-7526

Interoperability endpoints

  • Direct secure messaging: khushali.patel.p1@direct.ppmarmonte.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1740922251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262203",
            "telephone_number": "408-287-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KHUSHALI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.