NPIMap

Individual provider Active NPI

Shilpa Shetty, MD

  • Internal Medicine Physician
  • Derby, CT
National Provider Identifier
1316194517
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
048513 Issued in CT
Practice address
67 Maple Ave
Derby, CT 06418-1328
Phone
(203) 732-7328
Fax
(203) 732-1332
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 048513 CT Primary

Addresses

Primary practice location

67 Maple Ave
Derby, CT 06418-1328

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-7328

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshetty225592@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100826000205 CT Practitioner - EndocrinologyPractitioner - Internal Medicine 3870617970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endocrine Assoc of CT LLCGroup PAC ID 0840257192, 10 clinicians

Practice addresses (Care Compare)

1952 Whitney Ave
Suite 14
Hamden, CT 06517-1209
Phone (203) 776-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048513CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Assoc of CT LLC CurrentSince Nov 1, 2022 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine PastSince Nov 1, 2022 Accepting new patients

Locations

1952 Whitney Ave
Ste 14
Hamden, CT 06517
Phone (203) 766-4444

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

1952 Whitney Ave
New Haven, CT 06517
Phone (203) 553-7626

1389 W Main St
Ste 224
Waterbury, CT 06708
Phone (203) 597-0393

Interoperability endpoints

  • Direct secure messaging: sshetty589142@direct.ynhh.org

Organizations & group practices 4

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 5

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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1316194517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-7328",
            "fax_number": "203-732-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-7328",
            "fax_number": "203-732-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "SHILPA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "048513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshetty225592@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1389 W Main St Ste 224",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067083104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.