Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083771398 Individual Practitioner Male Practitioner

Dr. Patrick E Phelan , MD

Pediatrics • Indio, CA

Professional Overview & Biography Verified Profile Summary

Dr. Patrick Phelan, MD is a registered healthcare professional specializing in Pediatrics in Indio, CA. Practice services are available at 82934 CIVIC CENTER DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

82934 Civic Center Dr

Indio, CA 922014308

Telephone 4426665076
Associated Practice Facility / Clinic
🏢 Sac Health System Facility NPI 1831624493

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Indio, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.5 Yrs
Regional Practice Density
9 Specialists

Practicing in Indio, CA (9612 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-11-29
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License CA C173151

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License IL 036-095191

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License GA 86455

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
036095191 1 (IL)

Secondary Practice Locations

2000 Lake Ave

Woodstock, IL 600987401

Phone: 8153377100

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Diana Gascon , MD

Family Medicine

NPI 1285665562

Doctor of Medicine (M.D.)

Jasmin Avelar , LCSW

Social Worker - Clinical

NPI 1407642630

Licensed Clinical Social Worker

Rucha Juarez

Counselor - Mental Health

NPI 1679406342
Jessica Villarreal

Social Worker - Clinical

NPI 1760864847
Maria Lasam , NP

Nurse Practitioner - Family

NPI 1881138907

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location December 01, 2022

Registered at 82934 CIVIC CENTER DR, INDIO, CA 922014308 (Tel: 4426665076)

📍
Updated Business Mailing Address December 01, 2022

Registered at 11175 CAMPUS ST # A-1111, LOMA LINDA, CA 923501700 (Tel: 9095588142)

📍
Updated Practice Location February 22, 2021

Registered at 1500 OGLETHORPE AVE BLDG 600EF, ATHENS, GA 306062179 (Tel: 7066135980)

📍
Updated Business Mailing Address February 22, 2021

Registered at PO BOX 117264, ATLANTA, GA 303687264

📍
Updated Practice Location October 12, 2020

Registered at 1500 OGLETHORPE AVE BLDG 600, ATHENS, GA 306062179 (Tel: 7065493426)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2020

Pediatrics (License #036-095191 in IL)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2000 LAKE AVE, WOODSTOCK, IL 600987401 (Tel: 8153377100)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2000 LAKE AVE, WOODSTOCK, IL 600987401 (Tel: 8153377100)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as PATRICK PHELAN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics

🟢
Initial NPI Registration & Enumeration January 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083771398
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 03, 2007
Last Update: December 01, 2022
Sole Proprietor: No

Mailing Address

11175 Campus St # A-1111

Loma Linda, CA 923501700

Phone: 9095588142

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.