Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shivani Patel, PA-C

Individual provider Physician Assistant · NPI 1215379904

Shivani Patel, PA-C is a Physician Assistant in Cocoa Beach, Florida. Qualified in 2012, 14 years ago. Practices with Shadetree Dermatology LLC, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
14
Licensed in
FL
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

105 S Banana River Blvd Fl 2
Cocoa Beach, FL 32931-5041
Phone: (321) 200-0346
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 389 Commerce Pkwy Ste 160, Rockledge, FL 32955-4202 — (321) 200-0346

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9106944 (FL)

Record details

NPI number1215379904
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 23, 2013
Last updated in NPPESFebruary 27, 2026
Certification dateFebruary 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Shadetree Dermatology Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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