Individual provider Active NPI

Kshamata Shalini, MD

  • Internal Medicine Physician
  • Weston, WI
National Provider Identifier
1023099306
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40875-20 Issued in WI
Practice address
3400 Ministry Pkwy
Weston, WI 54476-5220
Phone
(715) 393-3000
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04S962 GA
Internal Medicine Physician 207R00000X 40875-20 WI Primary

Addresses

Primary practice location

3400 Ministry Pkwy
Weston, WI 54476-5220

Mailing address

3400 Ministry Pkwy
Weston, WI 54476-5220
Phone (715) 393-1000

Other practice location 1

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-4200

Other identifiers 2

IdentifierTypeStateIssuer
40875-20OtherWIWI STATE LIC
32592000MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031209000630 WI Practitioner - Internal Medicine 0840196036 Reassigns benefits to 12 organizations
I20211026000912 WI Practitioner - HospitalistPractitioner - Internal Medicine 0840196036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Langlade Hospital - Hotel Dieu of St Joseph of Antigo WisconsinGroup PAC ID 1557271202, shared by 7 NPIs, 86 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

110 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2351

112 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2331

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

Hospital & facility affiliations

  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113
  • Langlade Hospital Hospital, Antigo, WI, CCN 521350
  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193
  • Aspirus Merrill Hospital Hospital, Merrill, WI, CCN 521339

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04S962GAMDInternal Medicine Physician
40875-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Nov 11, 2021 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Nov 11, 2013 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Oct 1, 2012 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Dec 1, 2011 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 2, 2014 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 11, 2021 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Nov 1, 2010 Accepting new patients
Aspirus Wausau Hospital, Inc. Internal Medicine Current Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc. CurrentSince May 31, 2014 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jan 13, 2013 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Nov 1, 2010 Accepting new patients
MCHS Hospitals Inc Internal Medicine CurrentSince Nov 11, 2021 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Aug 8, 2011 Accepting new patients
Baycare Aurora, LLC CurrentSince Oct 10, 2023 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine CurrentSince Jan 2, 2014 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Nov 11, 2013 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Aug 8, 2011 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc CurrentSince May 31, 2014 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Oct 1, 2012 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jan 13, 2013 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin CurrentSince Dec 1, 2011 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

3100 Shore Dr
Ste 111
Marinette, WI 54143
Phone (715) 732-8212

3100 Shore Dr
Ste 106
Marinette, WI 54143
Phone (715) 732-8230

3100 Shore Dr
Marinette, WI 54143
Phone (715) 735-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

3400 Ministry Pkwy
Weston, WI 54476
Phone (715) 393-1000

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10114/brand/2/csg/1/fhir/r4
  • Direct secure messaging: kshamata.shalini@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: kshalini98129@direct.myadvocateaurora.org

Organizations & group practices 23

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.

View all 23

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1023099306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MINISTRY PKWY",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765220",
            "telephone_number": "715-393-1000",
            "fax_number": "715-393-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MINISTRY PKWY",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544765220",
            "telephone_number": "715-393-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 University Dr",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541434110",
            "country_code": "US",
            "telephone_number": "715-735-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHALINI",
        "first_name": "KSHAMATA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "04S962",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "40875-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LIC",
            "identifier": "40875-20",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32592000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3400 Ministry Pkwy",
            "city": "Weston",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544765220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.