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

Siddharth Shailesh Patel

Individual provider Physician Assistant · NPI 1205553914

Siddharth Shailesh Patel is a Physician Assistant in South Boston, Virginia. Qualified in 2023, 3 years ago. Practices as a sole proprietor and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2022

Practice location Address checks out

6046 Bill Tuck Hwy
South Boston, VA 24592-6442
Phone: (434) 222-5012
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1205553914
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 24, 2022
Last updated in NPPESOctober 24, 2022
Certification dateOctober 24, 2022
Mailing address6046 Bill Tuck Hwy, South Boston, VA 24592-6442

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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