Individual provider Active NPI

Ninad P Shet, MD

  • Internal Medicine Physician
  • Roswell, NM
National Provider Identifier
1346521218
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2014-0640 Issued in NM
Practice address
1511 South Grand
Roswell, NM 88203
Phone
(575) 623-3255
Fax
(575) 625-9901
NPI assigned
Sep 6, 2011
Last updated
Aug 27, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2014-0640 NM Primary
Internal Medicine Physician 207R00000X BP10041385 TX

Addresses

Primary practice location

1511 South Grand
Roswell, NM 88203

Mailing address

PO Box 843
Portales, NM 88130-0843
Phone (575) 623-3255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20141114001715 NM Practitioner - Internal Medicine 9638391212 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2014-0640NMMDInternal Medicine Physician
BP10041385TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Casa de Buena Salud Inc CurrentSince Sep 1, 2014 Accepting new patients
La Casa de Buena Salud Inc. CurrentSince Sep 1, 2014 Accepting new patients
La Casa de Buena Salud Inc Past Accepting new patients

Locations

1515 W Fir St
Portales, NM 88130
Phone (505) 356-6695

200 W Wilshire Blvd
Ste A
Roswell, NM 88201
Phone (575) 622-5956

1511 S Grand Ave
Roswell, NM 88203
Phone (505) 623-3255

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1346521218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881300843",
            "telephone_number": "575-623-3255",
            "fax_number": "575-625-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 SOUTH GRAND",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88203",
            "telephone_number": "575-623-3255",
            "fax_number": "575-625-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHET",
        "first_name": "NINAD",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2014-0640",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10041385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.