NPIMap

Individual provider Active NPI

Pankaj Shukla, MD

  • Internal Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1114937190
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A638720 Issued in CA
Practice address
9900 Stockdale Hwy Ste 107
Bakersfield, CA 93311-3633
Phone
(661) 664-0600
Fax
(661) 664-0621
NPI assigned
Aug 9, 2006
Last updated
Apr 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A638720 CA Primary

Addresses

Primary practice location

9900 Stockdale Hwy Ste 107
Bakersfield, CA 93311-3633

Mailing address

PO Box 20160
Bakersfield, CA 93390
Phone (661) 664-0600

Other identifiers 1

IdentifierTypeStateIssuer
00A638720MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311001488 CA Practitioner - Internal Medicine 3476442062 Reassigns benefits to 1 organization
Practice locations: Bakersfield, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9900 Stockdale Hwy
Suite 107
Bakersfield, CA 93311-3633
Phone (661) 664-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
76.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A638720CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Oaks Medical Group Inc Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Dignity Health Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
San Joaquin Community Hospital Past Accepting new patients
Onyinye Okezie MD Inc PastSince Apr 1, 2020 Accepting new patients

Locations

9900 Stockdale Hwy
Ste 107
Bakersfield, CA 93311
Phone (661) 664-0600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1114937190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20160",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93390",
            "telephone_number": "661-664-0600",
            "fax_number": "661-664-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 STOCKDALE HWY STE 107",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113633",
            "telephone_number": "661-664-0600",
            "fax_number": "661-664-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "PANKAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A638720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A638720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.