NPIMap

Individual provider Active NPI

Ajay Shetty, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Scranton, PA
National Provider Identifier
1053498170
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
MD059970L Issued in PA
Practice address
1800 Mulberry St.
Scranton, PA 18510-6800
Phone
(570) 703-8231
NPI assigned
Nov 1, 2006
Last updated
Aug 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD059970L PA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD059970L PA Primary

Addresses

Primary practice location

1800 Mulberry St.
Scranton, PA 18510-6800

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
0017169700003MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashetty138730@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050621000961 PA Practitioner - Pulmonary Disease 9133164197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD059970LPAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Scranton Quincy Clinic Company LLC Critical Care Medicine CurrentSince Jun 1, 2012 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2016 Accepting new patients
Geisinger Clinic Critical Care Medicine Past Accepting new patients
Scranton Clinic Company LLC Past Accepting new patients
Scranton Clinic Company LLC Pulmonary Disease Past Accepting new patients

Locations

150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031

100 N Academy Ave
Danville, PA 17822

315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

3 W Olive St
Ste 201
Scranton, PA 18508
Phone (570) 961-9947

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

746 Jefferson Ave
Fl 3
Scranton, PA 18510
Phone (570) 230-0045

802 Jefferson Ave
Scranton, PA 18510
Phone (570) 346-7331

Organizations & group practices 6

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1053498170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MULBERRY ST.",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185106800",
            "telephone_number": "570-703-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "AJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD059970L",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "PA",
            "license": "MD059970L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017169700003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashetty138730@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Mulberry St.",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185106800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.