Individual provider Active NPI

Vikram Govindaraju Shakkottai, M.D.

  • Neurology Physician
  • Ann Arbor, MI
National Provider Identifier
1033204615
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301091394 Issued in MI
Practice address
4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone
(734) 764-6831
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301091394 MI Primary

Addresses

Primary practice location

4260 Plymouth Rd
Ann Arbor, MI 48109-2700

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210422000841 TX Practitioner - Neurology 6204903073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5303 Harry Hines Blvd
FL 6
Dallas, TX 75390-7208
Phone (214) 645-2020

Hospital & facility affiliations

  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091394MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Neurology CurrentSince Mar 1, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 1, 2021 Accepting new patients

Locations

5303 Harry Hines Blvd
Fl 6
Dallas, TX 75390
Phone (214) 645-2225

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

5303 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-2300

Interoperability endpoints

  • Direct secure messaging: vshakkottai28399@direct.med.umich.edu

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 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1033204615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092700",
            "telephone_number": "734-764-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKKOTTAI",
        "first_name": "VIKRAM",
        "middle_name": "GOVINDARAJU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301091394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.