Individual provider Active NPI

Shyama K Kamat, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Murrieta, CA
National Provider Identifier
1083730105
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
A108518 Issued in CA
Practice address
25500 Medical Center Dr
Murrieta, CA 92562-5965
Phone
(951) 696-6000
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A108518 CA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X A108518 CA Primary

Addresses

Primary practice location

25500 Medical Center Dr
Murrieta, CA 92562-5965

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

14971 Holt Ave
Tustin, CA 92780-3406
Phone (949) 356-7676

Other practice location 2

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 966-8800

Other identifiers 1

IdentifierTypeStateIssuer
1083730105MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 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
I20231103001118 TX Practitioner - Emergency Medicine 8729257365 Reassigns benefits to 1 organization
I20250403003226 CA Practitioner - Emergency Medicine 8729257365 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A108518CAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Dec 15, 2023 Accepting new patients
Rady Children's Hospital San Diego Pediatrics CurrentSince Feb 1, 2025 Accepting new patients
Rady Children's Hospital San Diego CurrentSince Feb 1, 2025 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Jan 5, 2025 Accepting new patients
PM Pediatrics of California Professional Corporation Pediatrics Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1083730105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 MEDICAL CENTER DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625965",
            "telephone_number": "951-696-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14971 Holt Ave",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803406",
            "country_code": "US",
            "telephone_number": "949-356-7676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-966-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMAT",
        "first_name": "SHYAMA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A108518",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A108518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083730105",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.