Individual provider Active NPI

Shashank Siddhalingappa Shettar, M.D.

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1104171412
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
33373 Issued in OK
Practice address
920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104
Phone
(405) 271-4351
Fax
(405) 271-8695
NPI assigned
Jul 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 33373 OK Primary

Addresses

Primary practice location

920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104

Mailing address

PO Box 26901
Oklahoma City, OK 73126-0901
Phone (405) 271-4351

Other practice location 1

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-6950

Other practice location 2

920 Stanton L Young Blvd # Wp1140
Oklahoma City, OK 73104
Phone (405) 271-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20180627001621 OK Practitioner - Anesthesiology 5193023299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2018 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2018 Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

920 Stanton L Young Blvd
#1140
Oklahoma City, OK 73104
Phone (405) 271-4515

920 Stanton L Young Blvd
Ste 1140
Oklahoma City, OK 73104

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1104171412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26901",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260901",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STANTON L YOUNG BLVD # WP1140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73104",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-6950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Stanton L Young Blvd # Wp1140",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "73104",
            "country_code": "US",
            "telephone_number": "405-271-4351",
            "fax_number": "405-271-8695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTAR",
        "first_name": "SHASHANK",
        "middle_name": "SIDDHALINGAPPA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "33373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.