NPIMap

Individual provider Active NPI

Prakash T Patel, MD

  • Cardiovascular Disease Physician
  • Covina, CA
National Provider Identifier
1902987613
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A034471 Issued in CA
Practice address
315 N 3Rd Ave
# 306
Covina, CA 91723
Phone
(626) 332-1815
Fax
(626) 966-9685
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A034471 CA Primary

Addresses

Primary practice location

315 N 3Rd Ave
# 306
Covina, CA 91723

Mailing address

315 N 3Rd Ave
# 306
Covina, CA 91723
Phone (626) 332-1815

Other identifiers 1

IdentifierTypeStateIssuer
00A344710MedicaidCA

Other names 1

  • Mr. Prakashchandra T Patel Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100519000010 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 4284763921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

315 N 3Rd Ave
Suite 306
Covina, CA 91723-1916
Phone (626) 332-1815

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A034471CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centrelake Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Dr Prakashchandra Patel MD Inc a Professional Corporation Cardiovascular Disease CurrentSince Jan 1, 1973 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Locations

315 N 3rd Ave
Ste 306
Covina, CA 91723
Phone (626) 332-1815

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902987613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N 3RD AVE",
            "address_2": "# 306",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91723",
            "telephone_number": "626-332-1815",
            "fax_number": "626-966-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N 3RD AVE",
            "address_2": "# 306",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91723",
            "telephone_number": "626-332-1815",
            "fax_number": "626-966-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRAKASH",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A034471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A344710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRAKASHCHANDRA",
            "last_name": "PATEL",
            "middle_name": "T",
            "prefix": "MR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.