SHIV PATEL (DPT) – Physical Therapist, NPI 1114639440

SHIV PATEL (DPT) is a healthcare provider. based in Tifton, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT016353 (GA). The NPI Number for SHIV PATEL (DPT) is 1114639440

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
SHIV PATEL (DPT)
NPI
1114639440
Phone
(229) 326-9881
Address
3028 PARK AVE N
Enumeration Date
19 December 2022
Last Update Date
17 October 2024

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
4047783350
Graduation Year
2022 (4 years ago)
PAC ID
1153794854
Group Practice PAC ID
1153382676
Professional Enrollment ID
I20230228001494
Address ID
GA303292315AT21XXXLNXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for SHIV PATEL (DPT)

  • 3028 PARK AVE N

    TIFTON, GA 317942863

    Phone: (229) 326-9881

    Type: Mailing

  • 50 EXECUTIVE PARK S APT 406

    ATLANTA, GA 303292233

    Phone: (229) 326-9881

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-02-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230228001494IPhysical Therapist In Private PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31794)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153382676View full group profile
NameSpecialtyState
-GA
-TN
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeTN
-GA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA

Reviews

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Frequently asked questions

Where can patients find SHIV PATEL (DPT)'s NPI?
You can confirm SHIV PATEL (DPT) with NPI 1114639440; it appears in the national provider directory.
Is SHIV PATEL (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SHIV PATEL (DPT)'s specialty in plain language?
Clinically, the directory lists SHIV PATEL (DPT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place SHIV PATEL (DPT)?
The snapshot lists Tifton, Georgia for SHIV PATEL (DPT); download NPPES for the complete set.
Is SHIV PATEL (DPT) a real provider?
This page reflects official NPPES data for NPI 1114639440. Always confirm identity and privileges with the practice and licensing boards.

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