Active NPI
Shefali Dwarkanath Awatani, MD
- Internal Medicine Physician
- Lodi, CA
National Provider Identifier
1194860460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A85464
- Practice address
- 975 S Fairmont Ave
Lodi, CA 95240 - Phone
- (209) 334-3411
- Fax
- (209) 368-3121
- NPI assigned
- Feb 21, 2007
- Last updated
- Oct 19, 2007
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A85464 | CA | Primary |
Addresses
Primary practice location
975 S Fairmont Ave
Lodi, CA 95240
Mailing address
2638 Cranston CT.
Tracy, CA 95377
Phone (209) 830-7118
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A85464 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quantum Healthcare Medical Associates Inc. | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Hospitalist Physician
- Colton, CA
- NPI 1568490597
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192752000000",
"number": "1194860460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2638 CRANSTON CT.",
"city": "TRACY",
"state": "CA",
"postal_code": "95377",
"telephone_number": "209-830-7118",
"fax_number": "209-830-7118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 S FAIRMONT AVE",
"city": "LODI",
"state": "CA",
"postal_code": "95240",
"telephone_number": "209-334-3411",
"fax_number": "209-368-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AWATANI",
"first_name": "SHEFALI",
"middle_name": "DWARKANATH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A85464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.