Active NPI
Shanthala J Shivananjappa, M.D.
- Anesthesiology Physician
- Boston, MA
National Provider Identifier
1194715334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 217119
- Practice address
- 50 Staniford Street
C/O Ma Anesthesia Corp
Boston, MA 02114 - Phone
- (617) 665-1630
- NPI assigned
- Oct 27, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 217119 | MA | Primary |
Addresses
Primary practice location
50 Staniford Street
C/O Ma Anesthesia Corp
Boston, MA 02114
Mailing address
P.O. Box 372
C/O Ma Anesthesia Corp.
Stoughton, MA 02072-0372
Phone (781) 341-3966
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2030331 | Medicaid | MA | |
| 467250 | Other | MA | TUFTS HEALTH PLAN |
| J26878 | Other | MA | BCBS MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Public Health Commission | Past | Accepting new patients | |
| Cambridge Public Health Commission | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1932313228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1194715334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 372",
"address_2": "C/O MA ANESTHESIA CORP.",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "020720372",
"telephone_number": "781-341-3966",
"fax_number": "617-726-2894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 STANIFORD STREET",
"address_2": "C/O MA ANESTHESIA CORP",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-665-1630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVANANJAPPA",
"first_name": "SHANTHALA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-27",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "217119",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2030331",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "467250",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MA",
"identifier": "J26878",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.