Active NPI 1215379904 Individual Practitioner Female Practitioner

Shivani Patel , PA-C

Physician Assistant • Cocoa Beach, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Shivani Patel, PA-C is a certified Physician Assistant practicing in Cocoa Beach, FL. With approximately 14 years of clinical experience since completing medical education in 2012, Shivani Patel delivers high-quality medical care to the local community at 105 S BANANA RIVER BLVD FL 2.

Shivani Patel is affiliated with Shadetree Dermatology Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, tangential biopsy of single skin lesion. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

105 S Banana River Blvd Fl 2

Cocoa Beach, FL 329315041

Telephone 3212000346

Associated Practice Facility / Clinic

🏢 Shadetree Dermatology Llc Facility NPI 1366297376

Medicare Profile & Education

Medical School

Other

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Cocoa Beach, FL

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

14 Yrs +3.0 yrs vs City Avg

City Avg: 11.0 Yrs

State Avg: 11.1 Yrs

Regional Practice Density

8 Specialists

Practicing in Cocoa Beach, FL (10376 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

61.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Patel (14 Years) 14 Yrs

Cocoa Beach Specialty Average (11.0 Years) 11.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,295	249	$12.93	$5.28
99213 Established patient office or other outpatient visit, typically 15 minutes	697	584	$179.87	$75.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	660	532	$254.66	$105.81
11102 Tangential biopsy of single skin lesion	463	376	$198.63	$68.32
17004 Destruction of precancer skin growth, 15 or more growths	453	324	$332.83	$136.06
17110 Destruction of up to 14 skin growths	451	373	$222.25	$89.67
17000 Destruction of skin growth	450	373	$132.79	$39.72
11103 Biopsy of related skin growth, each additional growth	202	117	$99.59	$40.57
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	98	94	$111.74	$46.71
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	54	49	$785.54	$383.82
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	52	47	$267.24	$106.64
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	46	37	$354.11	$125.38
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	43	40	$599.73	$248.40
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	41	34	$483.46	$105.27
J9260 Injection, methotrexate sodium, 50 mg	35	18	$5.92	$2.67
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$222.90	$92.92
11200 Removal of skin tag, 1-15 skin tags	32	31	$181.85	$49.92
11900 Injection into skin growth, 1-7 growths	25	21	$113.50	$37.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$333.44	$139.50
96405 Administration of chemotherapy into growth, 1-7	23	14	$161.37	$47.82
11104 Punch biopsy, first skin growth	17	16	$245.92	$95.79
69100 Biopsy of ear	15	14	$190.00	$57.15
10040 Acne surgery	15	15	$228.98	$94.95
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	14	13	$2.44	$0.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,127	428	$13.67	$5.37
99213 Established patient office or other outpatient visit, typically 15 minutes	944	687	$181.32	$75.12
17000 Destruction of skin growth	814	569	$134.35	$38.36
17110 Destruction of up to 14 skin growths	457	362	$224.35	$83.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	381	310	$255.71	$106.20
11102 Tangential biopsy of single skin lesion	336	292	$201.88	$67.58
17004 Destruction of precancer skin growth, 15 or more growths	321	225	$335.00	$139.78
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	178	127	$203.82	$55.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	163	131	$113.33	$46.92
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	157	111	$244.95	$79.64
11103 Biopsy of related skin growth, each additional growth	138	95	$100.91	$41.18
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	87	71	$489.03	$106.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$226.50	$93.48
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	82	73	$234.00	$77.11
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	61	45	$357.11	$116.81
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	60	55	$605.08	$243.48
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	53	47	$277.89	$102.92
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	52	45	$798.69	$384.80
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	51	45	$275.69	$112.43
11104 Punch biopsy, first skin growth	37	36	$251.51	$98.52
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	36	33	$215.00	$64.24
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	36	31	$276.00	$102.66
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	27	25	$802.00	$330.75
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	21	19	$247.00	$89.81
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	20	19	$858.00	$354.49
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	14	$347.05	$71.38
11900 Injection into skin growth, 1-7 growths	18	18	$114.00	$27.61
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	18	18	$3.56	$1.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$336.89	$139.69
11200 Removal of skin tag, 1-15 skin tags	15	15	$181.53	$48.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,695	371	$13.89	$5.52
17000 Destruction of skin growth	732	486	$134.62	$37.87
99213 Established patient office or other outpatient visit, typically 15 minutes	711	494	$182.09	$76.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	403	291	$256.41	$107.51
17110 Destruction of up to 14 skin growths	343	261	$224.92	$81.75
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	291	196	$203.91	$58.10
17004 Destruction of precancer skin growth, 15 or more growths	233	136	$334.48	$140.17
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	194	129	$245.26	$83.67
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	166	119	$234.22	$75.87
11102 Tangential biopsy of single skin lesion	158	140	$204.11	$60.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	120	101	$113.83	$47.52
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	113	84	$490.40	$105.05
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	91	69	$279.10	$104.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	73	73	$226.89	$95.57
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	68	59	$214.96	$63.12
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	61	54	$276.66	$102.08
11104 Punch biopsy, first skin growth	59	55	$253.54	$99.36
11103 Biopsy of related skin growth, each additional growth	58	31	$102.21	$42.90
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	58	48	$858.57	$358.25
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	46	39	$803.57	$334.39
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	38	36	$247.21	$88.73
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	36	29	$358.00	$123.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$338.14	$142.58
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	27	16	$4.00	$1.18
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	25	22	$810.00	$387.56
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	25	22	$280.00	$117.27
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	21	20	$607.00	$249.03
11900 Injection into skin growth, 1-7 growths	20	16	$113.95	$27.39
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	19	$284.58	$116.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,421	357	$12.90	$5.34
17000 Destruction of skin growth	690	453	$130.92	$36.71
99213 Established patient office or other outpatient visit, typically 15 minutes	536	394	$181.77	$78.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	517	380	$255.34	$110.68
17110 Destruction of up to 14 skin growths	429	320	$222.94	$77.09
17004 Destruction of precancer skin growth, 15 or more growths	220	144	$327.12	$139.81
11104 Punch biopsy, first skin growth	213	187	$254.59	$106.64
11102 Tangential biopsy of single skin lesion	190	154	$203.14	$67.51
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	140	114	$111.85	$47.84
11103 Biopsy of related skin growth, each additional growth	128	74	$105.07	$44.48
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	111	83	$203.00	$53.20
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	82	70	$247.00	$87.81
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	79	59	$494.99	$110.70
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	63	51	$236.00	$78.52
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	61	37	$354.56	$117.28
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	59	47	$280.22	$101.24
11200 Removal of skin tag, 1-15 skin tags	54	49	$178.87	$47.62
11105 Punch biopsy, each additional skin growth	46	41	$121.00	$51.84
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	43	37	$280.00	$99.68
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	43	37	$869.00	$357.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$338.77	$142.28
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	35	35	$225.71	$96.71
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	27	25	$810.67	$347.74
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	18	15	$214.00	$63.74
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	18	18	$614.00	$255.93
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	14	13	$319.00	$131.74
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	11	11	$249.00	$92.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,279	331	$11.06	$5.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	668	502	$208.31	$93.41
17000 Destruction of skin growth	636	433	$127.02	$35.29
11104 Punch biopsy, first skin growth	383	306	$230.40	$105.06
17110 Destruction of up to 14 skin growths	336	256	$210.01	$77.34
99213 Established patient office or other outpatient visit, typically 15 minutes	277	212	$144.67	$64.45
11102 Tangential biopsy of single skin lesion	263	193	$176.51	$69.74
11103 Biopsy of related skin growth, each additional growth	259	149	$96.64	$45.44
17004 Destruction of precancer skin growth, 15 or more growths	143	98	$296.67	$134.91
11105 Punch biopsy, each additional skin growth	136	92	$114.87	$51.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	85	69	$84.22	$38.90
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	51	43	$475.53	$108.30
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	46	40	$331.20	$131.03
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	34	29	$832.85	$371.34
11200 Removal of skin tag, 1-15 skin tags	30	27	$174.13	$44.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$207.95	$92.90
69100 Biopsy of ear	19	19	$180.79	$57.67
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	15	14	$590.93	$235.68
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	15	15	$763.20	$345.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,160	362	$12.00	$4.84
17000 Destruction of skin growth	724	495	$132.00	$33.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	615	480	$219.00	$92.18
11104 Punch biopsy, first skin growth	512	401	$248.00	$103.84
99213 Established patient office or other outpatient visit, typically 15 minutes	371	290	$149.00	$62.95
11103 Biopsy of related skin growth, each additional growth	335	203	$107.00	$45.07
11102 Tangential biopsy of single skin lesion	332	244	$198.00	$68.45
17110 Destruction of up to 14 skin growths	315	258	$220.00	$70.37
11105 Punch biopsy, each additional skin growth	204	138	$123.00	$51.79
17004 Destruction of precancer skin growth, 15 or more growths	135	97	$307.00	$128.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	99	79	$90.00	$38.20
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	66	51	$357.00	$130.20
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	47	37	$503.00	$106.60
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	42	35	$614.00	$260.37
11200 Removal of skin tag, 1-15 skin tags	37	34	$178.00	$44.93
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	23	19	$292.00	$99.45
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	19	18	$873.00	$370.30
69100 Biopsy of ear	18	18	$198.00	$62.76
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$154.00	$65.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$219.00	$92.67
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	12	12	$306.00	$64.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,849	301	$11.00	$4.49
11100 Biopsy of single growth of skin and/or tissue	727	494	$211.00	$80.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	643	479	$214.00	$90.51
17000 Destruction of skin growth	639	422	$133.00	$37.46
99213 Established patient office or other outpatient visit, typically 15 minutes	500	355	$145.00	$61.13
11101 Biopsy of each additional growth of skin and/or tissue	443	252	$67.00	$27.95
17110 Destruction of up to 14 skin growths	219	181	$222.00	$92.17
17004 Destruction of precancer skin growth, 15 or more growths	148	93	$290.00	$121.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	107	84	$87.00	$36.44
99202 New patient office or other outpatient visit, typically 20 minutes	35	35	$150.00	$63.27
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	31	28	$353.00	$136.60
69100 Biopsy of ear	27	24	$202.00	$61.23
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	27	24	$289.00	$110.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$216.00	$91.95
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	18	$499.00	$110.14
40490 Biopsy of lip	17	12	$260.00	$93.45
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	15	14	$606.00	$254.96
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	13	13	$794.00	$322.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,718	288	$12.06	$4.77
17000 Destruction of skin growth	681	446	$134.75	$39.05
99213 Established patient office or other outpatient visit, typically 15 minutes	678	496	$146.96	$61.26
11100 Biopsy of single growth of skin and/or tissue	632	471	$207.18	$78.64
11101 Biopsy of each additional growth of skin and/or tissue	361	216	$67.00	$27.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	355	323	$216.00	$89.44
17110 Destruction of up to 14 skin growths	228	195	$221.11	$91.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	117	99	$88.00	$36.41
99202 New patient office or other outpatient visit, typically 20 minutes	112	112	$150.00	$62.70
17004 Destruction of precancer skin growth, 15 or more growths	92	63	$303.57	$125.39
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	40	31	$352.00	$128.78
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	35	35	$218.00	$91.28
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	22	21	$797.00	$322.28
69100 Biopsy of ear	20	17	$202.00	$65.48
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	18	15	$288.89	$95.73
11200 Removal of skin tag, 1-15 skin tags	11	11	$178.00	$37.19

Medical Specialties & State Licenses

CMS Verified: 2026-02-27

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA9106944

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Fl Rr Medicare

P01385335 (FL)

Commercial Insurance / Payer ID Fl Medicare

HP529Z (FL)

Hospital & Practice Group Affiliations

Shadetree Dermatology Llc

105 S Banana River Blvd, Cocoa Beach, FL 329315041

Phone: 3212000346

Secondary Practice Locations

389 Commerce Pkwy Ste 160

Rockledge, FL 329554202

Phone: 3212000346

Practice Associates & Co-Workers

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

3 Associated Practitioners

Elysia Dana , APRN

Nurse Practitioner - Family

NPI 1225673809

Advanced Practice Registered Nurse

Bonnie Fox , PA

Physician Assistant

NPI 1740590454

Physician Assistant

Dr. Vanessa Johnson , MD

Dermatology

NPI 1972948875

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

10 Historical Events

📍

Updated Practice Location February 27, 2026

Registered at 105 S BANANA RIVER BLVD FL 2, COCOA BEACH, FL 329315041 (Tel: 3212000346)

📍

Updated Business Mailing Address February 27, 2026

Registered at 105 S BANANA RIVER BLVD FL 2, COCOA BEACH, FL 329315041 (Tel: 3212000346)

📍

Updated Practice Location October 30, 2018

Registered at 7125 MURRELL RD STE A, VIERA, FL 329407999 (Tel: 3215749171)

📍

Updated Business Mailing Address October 30, 2018

Registered at 3300 S FISKE BLVD, ROCKLEDGE, FL 329554306 (Tel: 3214341982)

✅

NPI Profile Active November 04, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location November 04, 2013

Registered at 7125 MURRELL RD, VIERA, FL 329407999 (Tel: 3212428790)

📍

Updated Business Mailing Address November 04, 2013

Registered at 1223 GATEWAY DR, MELBOURNE, FL 329012607 (Tel: 3212428790)

👤

Provider Name / Credentials Updated November 04, 2013

Recorded as SHIVANI PATEL, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 04, 2013

Physician Assistant (License #PA9106944 in FL)

🟢

Initial NPI Registration & Enumeration July 23, 2013

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: 1215379904

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 23, 2013

Last Update: February 27, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

105 S Banana River Blvd Fl 2

Cocoa Beach, FL 329315041

Phone: 3212000346

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.