NPIMap

Individual provider Active NPI

Shubha Ananthakrishnan, MD

  • Nephrology Physician
  • Sacramento, CA
National Provider Identifier
1275633869
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A81348 Issued in CA
Practice address
4150 V St
#3500
Sacramento, CA 95817-1460
Phone
(916) 734-3774
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD26944 OR
Nephrology Physician 207RN0300X A81348 CA Primary

Addresses

Primary practice location

4150 V St
#3500
Sacramento, CA 95817-1460

Mailing address

4150 V St
#3500
Sacramento, CA 95817-1460
Phone (916) 734-3774

Other names 1

  • Shubha Mahadevan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000114 CA Practitioner - NephrologyPractitioner - Internal Medicine 2466453022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians

Practice addresses (Care Compare)

1189 E Herndon Ave
Suite 106
Fresno, CA 93720-3167
Phone (916) 773-4000

8110 Laguna Blvd
Elk Grove, CA 95758-8094
Phone (916) 683-3955

9390 Big Horn Blvd
Elk Grove, CA 95758-7978
Phone (916) 683-3955

Hospital & facility affiliations

  • Southgate Dialysis Dialysis facility, Sacramento, CA, CCN 052711
  • DaVita Arena Dialysis Dialysis facility, Sacramento, CA, CCN 552847
  • DaVita West Sacramento Dialysis Center Dialysis facility, West Sacramento, CA, CCN 552591
  • Dci University Dialysis Clinic Dialysis facility, Sacramento, CA, CCN 052676
  • DaVita Calvine Home Training Center Dialysis facility, Sacramento, CA, CCN 552747
  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81348CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Jan 1, 2012 Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 1, 2012 Accepting new patients
Regents of the University of California CurrentSince Jan 1, 2012 Accepting new patients
Regents of the University of California CurrentSince Jan 1, 2012 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients
University of California Davis Medical Center Nephrology Past Accepting new patients
Renal Treatment Centers West Inc PastSince May 29, 2008 Accepting new patients

Locations

9390 Big Horn Blvd
Ste 120
Elk Grove, CA 95758

9390 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 683-3950

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

1189 E Herndon Ave
Ste 106
Fresno, CA 93720
Phone (559) 436-8525

3850 G St
Merced, CA 95340
Phone (209) 384-6528

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

2315 Stockton Blvd
#5
Sacramento, CA 95817
Phone (916) 703-3050

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 100
Sacramento, CA 95817
Phone (916) 734-3588

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2221 Stockton Blvd
Ste E
Sacramento, CA 95817
Phone (916) 734-2680

100 N Wiget Ln
Ste 150
Walnut Creek, CA 94598
Phone (855) 420-2612

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1275633869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "#3500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "#3500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANTHAKRISHNAN",
        "first_name": "SHUBHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD26944",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A81348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUBHA",
            "last_name": "MAHADEVAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.