Individual provider Active NPI

Ishangi Divekar, PA-C

  • Physician Assistant
  • Carrboro, NC
National Provider Identifier
1104441328
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
301 Lloyd St
Carrboro, NC 27510-1823
Phone
(919) 942-8741
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

301 Lloyd St
Carrboro, NC 27510-1823

Mailing address

2182 Bristol Creek Dr
Morrisville, NC 27560-7883
Phone (773) 814-8751

Other names 1

  • Ishangi Shah Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1104441328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2182 BRISTOL CREEK DR",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275607883",
            "telephone_number": "773-814-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LLOYD ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101823",
            "telephone_number": "919-942-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVEKAR",
        "first_name": "ISHANGI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISHANGI",
            "last_name": "SHAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carrboro, NC

Sources for this page

Verify at the official NPI Registry.