Individual provider Active NPI

Punit S Patel, PA-C

  • Physician Assistant
  • Moreno Valley, CA
National Provider Identifier
1891319059
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA58376 Issued in CA
Practice address
12711 Scree Way
Moreno Valley, CA 92555-4566
Phone
(925) 999-0998
NPI assigned
Jun 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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 PA58376 CA Primary

Addresses

Primary practice location

12711 Scree Way
Moreno Valley, CA 92555-4566

Mailing address

12711 Scree Way
Moreno Valley, CA 92555-4566
Phone (925) 999-0998

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
I20210205001702 CA Practitioner - Physician Assistant 0840604682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17853 Santiago Blvd
Suite 107
Villa Park, CA 92861-4100

311 S Sunrise Way
Apt B18
Palm Springs, CA 92262-0827

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58376CAMDGeneral Practice Dentistry
PA58376CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Freeport Memorial Hospital Past Accepting new patients
Karma TMS PC PastSince May 29, 2022 Accepting new patients

Organizations & group practices 4

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": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1891319059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12711 SCREE WAY",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554566",
            "telephone_number": "925-999-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12711 SCREE WAY",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554566",
            "telephone_number": "925-999-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PUNIT",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.