Individual provider Active NPI

Shaija Shelby Kutty, MD

  • Pediatric Gastroenterology Physician
  • Baltimore, MD
National Provider Identifier
1093977209
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
D86316 Issued in MD
Practice address
600 N Wolfe Street
CMSC 2-116
Baltimore, MD 21287-0005
Phone
(410) 955-0106
Fax
(410) 955-1464
NPI assigned
Jun 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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 5759 NE
Pediatric Gastroenterology Physician 2080P0206X D86316 MD Primary

Addresses

Primary practice location

600 N Wolfe Street
CMSC 2-116
Baltimore, MD 21287-0005

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 933-6423

Other names 1

  • Shaija Shelby Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190402000187 MD Practitioner - Pediatric Medicine 6002030848 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5759NEMDPediatrics Physician
D86316MDMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Mar 1, 2019 Accepting new patients
Johns Hopkins University Pediatric Gastroenterology CurrentSince Mar 1, 2019 Accepting new patients
Johns Hopkins University Current Accepting new patients
The Johns Hopkins Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

600 N Wolfe St
#2116
Baltimore, MD 21287
Phone (410) 955-0106

4940 Eastern Ave
Baltimore, MD 21224

200 N Wolfe St
Baltimore, MD 21287
Phone (410) 614-3917

Interoperability endpoints

  • Direct secure messaging: sshelby2142@direct.chsomaha.org
  • Direct secure messaging: skutty515772@direct.hopkinsmedicine.org

Organizations & group practices 5

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": "1214697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1093977209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE STREET",
            "address_2": "CMSC 2-116",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-0106",
            "fax_number": "410-955-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTY",
        "first_name": "SHAIJA",
        "middle_name": "SHELBY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-29",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "5759",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MD",
            "license": "D86316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAIJA",
            "last_name": "SHELBY",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.