Benjamin D Shadle, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A99595 Issued in CA

Practice address

3 Medical Plaza
Suite 200
Roseville, CA 95661

Phone

(916) 773-8750

Fax

(916) 773-7963

NPI assigned

Nov 9, 2005

Last updated

Oct 19, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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

General Surgery

Education

Ohio State University College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Valley Medical FoundationGroup PAC ID 9830094515, shared by 24 NPIs, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
• Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
• Sutter Davis Hospital Hospital, Davis, CA, CCN 050537

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bshadle134581@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549
  Medicare reassignment NPD
• Surgical Affiliates of California

  • Surgery Physician
  • Los Banos, CA
  • NPI 1932440781
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  dba Briggsmore Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Modesto, CA
  • NPI 1346615150
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  dba Sutter North Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1457593980
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  dba Stockton Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Stockton, CA
  • NPI 1467825844
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Elk Grove, CA
  • NPI 1972877264
  Medicare reassignment NPD
• Dignity Community Care

  dba Methodist Hospital of Sacramento

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1467560599
  NPD (past)
• Dignity Health

  dba Mercy San Juan Medical Center

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  NPD (past)
• Lodi Memorial Hospital Association Inc

  dba Lodi Memorial Hospital Acute Physical Rehabilitation Unit

  • Rehabilitation Hospital Unit
  • Lodi, CA
  • NPI 1821028671
  NPD (past)
• Sutter Regional Medical Foundation

  • Family Medicine Physician
  • Fairfield, CA
  • NPI 1558388504

  Surgery

  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  NPD (past)

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

• Sutter Valley Hospitals

  dba Sutter Auburn Faith Hospital

  • General Acute Care Hospital
  • Auburn, CA
  • NPI 1194774299
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Roseville Medical Center

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • Home Health Agency
  • Auburn, CA
  • NPI 1417987751

  Hospital

  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Davis Hospital

  • General Acute Care Hospital
  • Davis, CA
  • NPI 1770532608
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1316928070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE ROAD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLAZA",
            "address_2": "SUITE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-773-8750",
            "fax_number": "916-773-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADLE",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A99595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sewa Senior Facility LLC
• Lahoma Rae Seymour
• Shannon Rae Sgro, P.A.-C
• Golzar Shaari, DDS
• Said Shaari, DDS
• Mansi Shah, M.D.
• Nandi Mukesh Shah, M.D.
• Sabrina Shah
• Sanket S Shah, PA
• Kavian Shahi, M.D., PH.D.

• Surgery Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.