Shaanan Satish Shetty, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

075374 Issued in GA

Practice address

1265 Upper Hembree Rd Ste 100
Roswell, GA 30076-1258

Phone

(770) 751-1133

Fax

(770) 751-7410

NPI assigned

Jun 20, 2012

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Dermatology

Education

Washington University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta Center for Dermatologic Diseases PCGroup PAC ID 3072569318, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sshetty@directaddress.net

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.

• Atlanta Center for Dermatologic Diseases PC

  • Dermatology Physician
  • Roswell, GA
  • NPI 1417910431
  Medicare reassignment Care Compare group NPD
• Northside Plastic Surgery

  • Plastic Surgery Physician
  • Roswell, GA
  • NPI 1740245950
  NPD (past)

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1346503810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761258",
            "telephone_number": "770-751-1433",
            "fax_number": "770-751-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761258",
            "telephone_number": "770-751-1133",
            "fax_number": "770-751-7410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Dahlonega St Ste 1501",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300408203",
            "country_code": "US",
            "telephone_number": "770-844-1902",
            "fax_number": "770-205-3991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "SHAANAN",
        "middle_name": "SATISH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "075374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshetty@directaddress.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "327 Dahlonega St Ste 1501",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300408203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Shepherd, NP
• Steven Shepperd, D.D.S.
• Linda Anne Sherbinski, CRNA
• David Sherwood, LAPC
• Jigish G Sheth, DO
• Shield Homecare
• Katherine Hufham Shiffer
• Lisa Shilman, D.D.S
• Hannah Elizabeth Shirling, BCBA
• Kristen E. Shoemaker, MAED, LPC

• Dermatology Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.