Individual provider Active NPI

Amit Ashok Shetty, DO

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Battle Ground, WA
National Provider Identifier
1356800148
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
OP61584994 Issued in WA
Practice address
2005 W Main St
Battle Ground, WA 98604-4311
Phone
(360) 882-2778
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X OP61584994 WA Primary

Addresses

Primary practice location

2005 W Main St
Battle Ground, WA 98604-4311

Mailing address

501 SE 172ND Ave
Vancouver, WA 98684-9542
Phone (360) 882-2778

Other practice location 1

501 SE 172nd Ave
Vancouver, WA 98684-9542
Phone (360) 882-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240807003656 WA Practitioner - Osteopathic Manipulative Medicine 8123351426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2005 W Main St
Battle Ground, WA 98604-4311
Phone (360) 882-2778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61584994WAMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Sep 23, 2024 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Sep 23, 2024 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

2005 W Main St
Battle Ground, WA 98604
Phone (360) 604-1600

2005 W Main St
Ste 220
Battle Ground, WA 98604

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

501 SE 172nd Ave
Ste 220
Vancouver, WA 98684
Phone (360) 882-2777

501 SE 172nd Ave
Vancouver, WA 98684

Interoperability endpoints

  • Direct secure messaging: ashetty24588@tvc-direct.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.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1356800148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SE 172ND AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849542",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W MAIN ST",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044311",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 SE 172nd Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986849542",
            "country_code": "US",
            "telephone_number": "360-882-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "AMIT",
        "middle_name": "ASHOK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "WA",
            "license": "OP61584994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

Verify at the official NPI Registry.