NPIMap

Individual provider Active NPI

Archana C Shende, M D

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1043255938
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A50235 Issued in CA
Practice address
1211 W la Palma Ave
Suite 309
Anaheim, CA 92801-2815
Phone
(714) 999-1050
Fax
(714) 999-2580
NPI assigned
Jun 17, 2006
Last updated
Apr 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A50235 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave
Suite 309
Anaheim, CA 92801-2815

Mailing address

1211 W la Palma Ave
Suite 309
Anaheim, CA 92801-2815
Phone (714) 999-1050

Other identifiers 1

IdentifierTypeStateIssuer
00A502350MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110822000148 CA Practitioner - Family PracticePractitioner - Internal Medicine 3274703756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
University of Southern California Keck School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1211 W la Palma Ave
Suite 309
Anaheim, CA 92801-2811
Phone (714) 999-1050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50235CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archana Shende M D Inc Internal Medicine CurrentSince Jan 9, 2002 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 309
Anaheim, CA 92801
Phone (714) 951-1910

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 8

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1043255938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 309",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-999-1050",
            "fax_number": "714-999-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 309",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-999-1050",
            "fax_number": "714-999-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENDE",
        "first_name": "ARCHANA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A502350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.