Individual provider Active NPI

Fatimat O Shotande, MD

  • Internal Medicine Physician
  • Roanoke, VA
National Provider Identifier
1023646759
Registry record updated Jun 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27461 Issued in NV
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 224-4635
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A199907 CA
Internal Medicine Physician 207R00000X 0101283722 VA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 27461 NV Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 974-2201

Other practice location 2

12746 W Jefferson Blvd Ste 4000
Playa Vista, CA 90094-2885
Phone (424) 315-2202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA, TX, FL, NV5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20241218000652 VA Practitioner - Internal Medicine 1254868060 Reassigns benefits to 1 organization
I20250318000559 CA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 1254868060 Reassigns benefits to 1 organization
I20250804002616 TX Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1254868060 Reassigns benefits to 1 organization
I20260506003775 FL Practitioner - Internal Medicine 1254868060 Reassigns benefits to 1 organization
I20260622003197 NV Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1254868060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

317 6TH Ave
Suite 400
Des Moines, IA 50309-4037

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A199907CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Mar 3, 2025 Accepting new patients
Carilion Medical Center CurrentSince Nov 22, 2024 Accepting new patients
Arctic Slope Native Association LTD Current Accepting new patients
Carilion Medical Center CurrentSince Nov 22, 2024 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Mar 3, 2025 Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

12746 W Jefferson Blvd
Ste 4000
Playa Vista, CA 90094
Phone (424) 315-2202

12746 W Jefferson Blvd
#4000
Playa Vista, CA 90094
Phone (310) 423-4898

12746 W Jefferson Blvd
Ste 2000
Playa Vista, CA 90094
Phone (424) 315-2220

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: fatimat.shotande.1@28334.direct.athenahealth.com

Organizations & group practices 7

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 1

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1023646759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-224-4635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Davis Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063438",
            "country_code": "US",
            "telephone_number": "813-974-2201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12746 W Jefferson Blvd Ste 4000",
            "address_purpose": "LOCATION",
            "city": "Playa Vista",
            "state": "CA",
            "postal_code": "900942885",
            "country_code": "US",
            "telephone_number": "424-315-2202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOTANDE",
        "first_name": "FATIMAT",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A199907",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101283722",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "27461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.