Individual provider Active NPI

Sonali Shukla, MD

  • Anatomic Pathology Physician
  • Laporte, IN
National Provider Identifier
1003862228
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
01060482A Issued in IN
Practice address
1007 Lincolnway
Laporte, IN 46350-3201
Phone
(219) 326-2403
Fax
(219) 326-2385
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 01060482A IN Primary

Addresses

Primary practice location

1007 Lincolnway
Laporte, IN 46350-3201

Mailing address

1007 Lincolnway
Post Office Box 1539
Laporte, IN 46350-3201
Phone (219) 326-2403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051029000074 IN Practitioner - Pathology 2163449000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates of Northwest Indiana IncGroup PAC ID 9537436589, 3 clinicians
Michiana Gastroenterology, IncGroup PAC ID 2163529892, 12 clinicians

Practice addresses (Care Compare)

1007 Lincolnway
La Porte, IN 46350-3201
Phone (219) 326-2307

53830 Generations Dr
South Bend, IN 46635-1557
Phone (574) 234-0049

Hospital & facility affiliations

  • Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006
  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01060482AINMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Gastroenterology, Inc CurrentSince Nov 1, 2017 Accepting new patients
Pathology Associates of Northwest Indiana Inc CurrentSince Jul 1, 2017 Accepting new patients
MG Anesthesia, LLC Past Accepting new patients

Locations

1331 State St
Laporte, IN 46350
Phone (219) 326-2415

1007 Lincolnway
Laporte, IN 46350
Phone (219) 325-5474

17501 Generations Dr
South Bend, IN 46635
Phone (574) 234-0049

53830 Generations Dr
South Bend, IN 46635
Phone (574) 217-0174

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1003862228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 LINCOLNWAY",
            "address_2": "POST OFFICE BOX 1539",
            "city": "LAPORTE",
            "state": "IN",
            "postal_code": "463503201",
            "telephone_number": "219-326-2403",
            "fax_number": "219-326-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LINCOLNWAY",
            "city": "LAPORTE",
            "state": "IN",
            "postal_code": "463503201",
            "telephone_number": "219-326-2403",
            "fax_number": "219-326-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "SONALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "IN",
            "license": "01060482A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laporte, IN

Sources for this page

Verify at the official NPI Registry.