Shivam Pinakin Patel

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

16728 Issued in GA

Practice address

1459 Laney Walker Blvd
Augusta, GA 30912-0002

Phone

(706) 721-2423

NPI assigned

Jun 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1750125209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4335 EMERALD PALMS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843504",
            "telephone_number": "863-624-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120002",
            "telephone_number": "706-721-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVAM",
        "middle_name": "PINAKIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "16728",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "16728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reena M Patel, MD
• Renita Anilkumar Patel
• Rudresh H Patel, DO
• Sahil Patel, MD
• Shiv Patel, MD
• Shreyal Chandrakant Patel, M.D.
• Sunil Rameshbhai Patel, MD
• Tarak Vipinchandra Patel, M.D.
• Tejalben Patel, PA
• Vijaykumar Surendrakant Patel, MD

• Ophthalmology Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.

Verify at the official NPI Registry.