Individual provider Active NPI

Shivakanth Burugu, M.D.

  • Nephrology Physician
  • New Iberia, LA
National Provider Identifier
1023334828
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
321121 Issued in LA
Practice address
224 N Lewis St
New Iberia, LA 70563-2841
Phone
(337) 560-1144
Fax
(337) 560-1102
NPI assigned
Apr 19, 2010
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD37848 SC
Nephrology Physician 207RN0300X 321121 LA Primary

Addresses

Primary practice location

224 N Lewis St
New Iberia, LA 70563-2841

Mailing address

300 W Saint Mary Blvd
Lafayette, LA 70506-4638
Phone (337) 233-6593

Other practice location 1

300 18th St Ste 200
Lake Charles, LA 70601-7342
Phone (337) 497-0366

Other identifiers 1

IdentifierTypeStateIssuer
2516825MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sburugu21184@direct.acumenmd.com
Direct Messaging Address sburugu21184@direct.acumenmd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, LA2 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
I20151103002716 SC Practitioner - NephrologyPractitioner - Internal Medicine 1850601865 Reassigns benefits to 1 organization
I20200407001731 LA Practitioner - Nephrology 1850601865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acadiana Renal Physicians AMCGroup PAC ID 5890783070, 16 clinicians

Practice addresses (Care Compare)

224 N Lewis St
New Iberia, LA 70563-2841
Phone (337) 560-1144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD37848SCMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pee Dee Nephrology LLP Nephrology CurrentSince Aug 17, 2015 Accepting new patients
Advanced Nutrition Consultants Inc CurrentSince Aug 17, 2015 Accepting new patients
Gulf Coast Nephrology, LLC Nephrology CurrentSince Apr 1, 2023 Accepting new patients
Acadiana Renal Physicians AMC Nephrology CurrentSince Jan 27, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

2804 Ambassador Caffery Pkwy
Lafayette, LA 70506
Phone (337) 981-5156

300 W Saint Mary Blvd
Lafayette, LA 70506
Phone (337) 233-1542

300 18th St
Ste 200
Lake Charles, LA 70601
Phone (337) 439-5369

224 N Lewis St
New Iberia, LA 70563
Phone (318) 364-1103

1100 E Cheves St
Florence, SC 29506
Phone (843) 669-6694

Interoperability endpoints

  • Direct secure messaging: sburugu422227@christushealth.direct-ci.net

Organizations & group practices 5

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

Hospital & facility affiliations 7

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1023334828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W SAINT MARY BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064638",
            "telephone_number": "337-233-6593",
            "fax_number": "337-235-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N LEWIS ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632841",
            "telephone_number": "337-560-1144",
            "fax_number": "337-560-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 18th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706017342",
            "country_code": "US",
            "telephone_number": "337-497-0366",
            "fax_number": "337-497-1367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURUGU",
        "first_name": "SHIVAKANTH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "MD37848",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "321121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2516825",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sburugu21184@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "224 N Lewis St",
            "city": "New Iberia",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705632841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sburugu21184@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "300 18th St Ste 200",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706017342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.