Individual provider Active NPI

Ishita Patel

  • Pediatrics Physician
  • Ventura, CA
National Provider Identifier
1780245563
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A176001 Issued in CA
Practice address
200 S Wells Rd Ste 100
Ventura, CA 93004-1378
Phone
(805) 647-6322
Fax
(805) 647-7164
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A176001 CA Primary

Addresses

Primary practice location

200 S Wells Rd Ste 100
Ventura, CA 93004-1378

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220822002242 CA Practitioner - Pediatric Medicine 7315320421 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176001CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Oct 17, 2022 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Aug 14, 2022 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Oct 17, 2022 Accepting new patients
Clinicas del Camino Real Inc PastSince Aug 14, 2022 Accepting new patients
Clinicas del Camino Real Inc PastSince Aug 14, 2022 Accepting new patients

Locations

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

200 S Wells Rd
Ste 100
Ventura, CA 93004
Phone (805) 647-6322

200 S Wells Rd
Ventura, CA 93004
Phone (805) 647-6322

Interoperability endpoints

  • Direct secure messaging: ishita.patel.p1@direct.clinicas.nextgenshare.com
  • Direct secure messaging: ipatel802677@direct.ochin.org

Organizations & group practices 5

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1780245563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041378",
            "telephone_number": "805-647-6322",
            "fax_number": "805-647-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ISHITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A176001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.