Individual provider Active NPI

Shanti Jampani, MD

  • Child & Adolescent Psychiatry Physician
  • Roseville, CA
National Provider Identifier
1174835433
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
C186368 Issued in CA
Practice address
1731 E Roseville Pkwy Ste 290
Roseville, CA 95661-6453
Phone
(844) 867-8444
Fax
(916) 836-3977
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2018010171 MO
Child & Adolescent Psychiatry Physician 2084P0804X ME118192 FL
Student in an Organized Health Care Education/Training Program 390200000X
Child & Adolescent Psychiatry Physician 2084P0804X C186368 CA Primary

Addresses

Primary practice location

1731 E Roseville Pkwy Ste 290
Roseville, CA 95661-6453

Mailing address

1731 E Roseville Pkwy Ste 290
Roseville, CA 95661-6453
Phone (844) 867-8444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210312002134 WI Practitioner - PsychiatryPractitioner - Other (Physician) 2264866698 Reassigns benefits to 1 organization
I20230927002982 CA Practitioner - Psychiatry 2264866698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1731 E Roseville Pkwy
Suite 290
Roseville, CA 95661-6453
Phone (844) 867-8444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C186368CAMDChild & Adolescent Psychiatry Physician
ME118192FLMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jan 14, 2021 Accepting new patients
Mindful Health Solutions a Professional Medical Corporation Psychiatry CurrentSince Oct 2, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince Jan 14, 2021 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Institute for Family Therapy Inc PastSince Aug 22, 2018 Accepting new patients

Locations

1020 Suncast Ln
Ste 108
El Dorado Hills, CA 95762
Phone (916) 932-0380

3300 Webster St
Ste 803
Oakland, CA 94609

8775 Sierra College Blvd
Ste 200
Roseville, CA 95661
Phone (916) 294-7062

1731 E Roseville Pkwy
Ste 290
Roseville, CA 95661
Phone (916) 262-9002

360 Post St
Ste 500
San Francisco, CA 94108
Phone (415) 671-6819

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1174835433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 E ROSEVILLE PKWY STE 290",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956616453",
            "telephone_number": "844-867-8444",
            "fax_number": "916-836-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 E ROSEVILLE PKWY STE 290",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956616453",
            "telephone_number": "844-867-8444",
            "fax_number": "916-836-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMPANI",
        "first_name": "SHANTI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2018010171",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME118192",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "C186368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.