Individual provider Active NPI

Shaguna Mathur, M.D

  • Neurology with Special Qualifications in Child Neurology Physician
  • New York, NY
National Provider Identifier
1225470396
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
346191 Issued in NY
Practice address
575 W 181St St
New York, NY 10033-5002
Phone
(212) 342-3060
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125064197 IL
Neurology Physician 2084N0400X 268576 MA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 346191 NY Primary
Neurodevelopmental Disabilities Physician 2084P0005X 31873 NE

Addresses

Primary practice location

575 W 181St St
New York, NY 10033-5002

Mailing address

630 W 168TH St # 4
New York, NY 10032-3725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20190806001842 NE Practitioner - Neurology 5294062857 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125064197ILMDPediatrics Physician
268576MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Father Flanagan'S Boys Home Past Accepting new patients
ENT Services PC Past Accepting new patients

Locations

14000 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6000

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1225470396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 W 181ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100335002",
            "telephone_number": "212-342-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "SHAGUNA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125064197",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "268576",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "346191",
            "primary": true
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NE",
            "license": "31873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.