Individual provider Active NPI

Shamita Trivedi, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Dallas, TX
National Provider Identifier
1114187903
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
N9003 Issued in TX
Practice address
12200 Park Central Dr Ste 200
Dallas, TX 75251-2120
Phone
(972) 685-2740
NPI assigned
Jun 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X N9003 TX Primary

Addresses

Primary practice location

12200 Park Central Dr Ste 200
Dallas, TX 75251-2120

Mailing address

12200 Park Central Dr Ste 200
Dallas, TX 75251-2120
Phone (972) 685-2740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181031002859 TX Practitioner - EndocrinologyPractitioner - Pediatric Medicine 3173876513 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayra Jimenez Thompson, MD PLLC CurrentSince Nov 3, 2024 Accepting new patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Connie Casad MD PLLC CurrentSince Nov 3, 2024 Accepting new patients

Locations

12200 Park Central Dr
Ste 200
Dallas, TX 75251
Phone (972) 528-5590

Interoperability endpoints

  • Direct secure messaging: shamita.trivedi@762391221567492.direct.elationemr.com

Organizations & group practices 3

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": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1114187903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512120",
            "telephone_number": "972-685-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512120",
            "telephone_number": "972-685-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "SHAMITA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-15",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "N9003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.