Samir Pravinchandra Patel, D.O.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

P3056 Issued in TX

Practice address

3903 Wiseman Blvd
Ste 311
San Antonio, TX 78251-4422

Phone

(210) 615-1901

Fax

(210) 615-1905

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spatel@jkp.gwaydirect.com

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.

• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Anesthesiology

  Medicare reassignment NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1760424873
  NPD

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1992965982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 117614",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750117614",
            "telephone_number": "210-615-1901",
            "fax_number": "210-615-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 WISEMAN BLVD",
            "address_2": "STE 311",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514422",
            "telephone_number": "210-615-1901",
            "fax_number": "210-615-1905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12602 Toepperwein Road",
            "address_2": "Ste 218",
            "address_purpose": "LOCATION",
            "city": "Live Oak",
            "state": "TX",
            "postal_code": "78233",
            "country_code": "US",
            "telephone_number": "210-615-1901",
            "fax_number": "210-615-1905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3603 Paesanos Pkwy",
            "address_2": "Ste 205A",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782311267",
            "country_code": "US",
            "telephone_number": "210-615-1901",
            "fax_number": "210-615-1905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAMIR",
        "middle_name": "PRAVINCHANDRA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P3056",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2013-01741",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "P3056",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "2013-01741",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "P3056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296904001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "296904002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronak A Patel
• Roshan Patel
• Roshni R Patel
• Ruchi Mukeshbhai Patel, MD
• Rupal Dilipbhai Patel, M.D.
• Sandeep Natvarlal Patel, DO
• Sapna Patel, DO
• Seema Patel, PHARM.D.
• Setu Dipak Patel
• Shaily D Patel, COTA

• Pain Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.