Individual provider Active NPI

Pooja Vinay Patel

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1962042556
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64345 Issued in CA
Practice address
2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jan 10, 2020
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 64345 CA Primary
Physician Assistant 363A00000X PA203141 OR
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR, ME, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20211230000359 GA Practitioner - Physician Assistant 3375934359 Reassigns benefits to 1 organization
I20230829003356 OR Practitioner - Physician Assistant 3375934359 Reassigns benefits to 1 organization
I20240706000139 ME Practitioner - Physician Assistant 3375934359 Reassigns benefits to 1 organization
I20250820003651 CA Practitioner - Physician Assistant 3375934359 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

2170 S Ave
South Lake Tahoe, CA 96150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64345CAMDDentist
PA203141ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Primary Care, Inc CurrentSince Jul 15, 2021 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Aug 14, 2023 Accepting new patients
Mainegeneral Medical Center CurrentSince Jun 5, 2024 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Aug 14, 2023 Accepting new patients
Mainegeneral Medical Center CurrentSince Jun 5, 2024 Accepting new patients

Locations

4025 Lawrenceville Hwy NW
Ste A
Lilburn, GA 30047
Phone (770) 559-3501

149 North St
Waterville, ME 04901
Phone (207) 622-1959

589 NW 11th St
Hermiston, OR 97838
Phone (503) 567-1717

8935 SE Powell Blvd
Portland, OR 97266
Phone (503) 349-7864

Interoperability endpoints

  • Direct secure messaging: ppatel215111@direct.renown.org

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 1

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": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1962042556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMBARCADERO CTR LBBY LEVEL",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113823",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POOJA",
        "middle_name": "VINAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64345",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA203141",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.