Keith Balram Shankar, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

326975 Issued in NY

Practice address

3898 Vineyard Dr Ste 1
Dunkirk, NY 14048-3559

Phone

(716) 363-6960

NPI assigned

Apr 9, 2020

Reactivated

Jan 25, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
• Willcare Chha (Buffalo) Home health agency, Buffalo, NY, CCN 337268
• Chautauqua Hospice and Palliative Care Hospice, Lakewood, NY, CCN 331554
• Brooks-TLC Hospital System, Inc Hospital, Dunkirk, NY, CCN 330229
• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshankar@gppc.medentdirect.com

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 Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brooks - TLC Hospital System Inc

  • Family Medicine Physician
  • Gowanda, NY
  • NPI 1538419502

  Hospital

  Care Compare affiliation
• Brooks - TLC Hospital System, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Derby, NY
  • NPI 1225654494

  Hospital

  Care Compare affiliation
• Brooks - TLC Hospital System, Inc.

  • Urgent Care Clinic/Center
  • Gowanda, NY
  • NPI 1487738886

  Hospital

  Care Compare affiliation
• Brooks-TLC Hospital System, Inc.

  • General Acute Care Hospital
  • Dunkirk, NY
  • NPI 1215917224
  Care Compare affiliation
• Chautauqua Hospice and Palliative Care

  • Community Based Hospice Care Agency
  • Lakewood, NY
  • NPI 1639255250
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation
• Visiting Nursing Association of Western New York, Inc.

  • Home Health Agency
  • Cheektowaga, NY
  • NPI 1730268384
  Care Compare affiliation
• Western Region Health Corporation

  • Home Health Agency
  • Amherst, NY
  • NPI 1710036298
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1225657364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142400488",
            "telephone_number": "716-852-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 VINEYARD DR STE 1",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140483559",
            "telephone_number": "716-363-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKAR",
        "first_name": "KEITH",
        "middle_name": "BALRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "deactivation_date": "2022-01-10",
        "reactivation_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "326975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigha Schimmoeller, DPT
• Nichole Elizabeth Schnell, PHARMD
• Marie Pauline Schrantz Damico, LMSW
• Paula Schuk
• Sarah Elizabeth Scullion, MS, RN, FNP-BC
• Brittany Sheehan
• Renae A.M. Sheldon Banach
• Kali Anne Sherbino, OTR/L
• Stephanie Elizabeth Simmes, RN
• Averey Simmons

• Family Medicine Physician in Dunkirk, NY
• Providers in Dunkirk, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.