Individual provider Active NPI

Neil Nitin Shankar, AMFT

  • Marriage & Family Therapist
  • Burlingame, CA
National Provider Identifier
1265253223
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT138198 Issued in CA
Practice address
700 Airport Blvd Ste 490&495
Burlingame, CA 94010-1908
Phone
(650) 517-8220
NPI assigned
Oct 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT138198 CA Primary

Addresses

Primary practice location

700 Airport Blvd Ste 490&495
Burlingame, CA 94010-1908

Mailing address

123 Nursery Way
South San Francisco, CA 94080-3291
Phone (650) 515-2776

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMFT138198CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Center for Children and Families CurrentSince Oct 27, 2024 Accepting new patients

Locations

700 Airport Blvd
Ste 490495
Burlingame, CA 94010
Phone (650) 517-8210

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1265253223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 NURSERY WAY",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803291",
            "telephone_number": "650-515-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 AIRPORT BLVD STE 490&495",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940101908",
            "telephone_number": "650-517-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKAR",
        "first_name": "NEIL",
        "middle_name": "NITIN",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT138198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.