Mahadevan Shetty, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

020421 Issued in CT

Practice address

385 Main St S,
C/O Nvra Union Square BLDG#1
Southbury, CT 06488-4240

Phone

(203) 264-7999

Fax

(203) 264-7477

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Health Imaging Associates

  • Mammography Clinic/Center
  • Waterbury, CT
  • NPI 1356363931
  NPD (past)
• Naugatuck Valley Computerized Imaging

  • Radiology Clinic/Center
  • Waterbury, CT
  • NPI 1225050800
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1386678290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 MAIN ST S,",
            "address_2": "C/O NVRA UNION SQUARE BLDG #1",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884240",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MAIN ST S,",
            "address_2": "C/O NVRA UNION SQUARE BLDG#1",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884240",
            "telephone_number": "203-264-7999",
            "fax_number": "203-264-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "MAHADEVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CT",
            "license": "020421",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "020421",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CT",
            "license": "020421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001204213",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherbarr Agency Dba Sherbarr Transportation
• Sherbarr Home Care Agency
• Sherri Rainingbird LLC
• Sheryl Lacoursiere LLC (Integral Psychiatric Services)
• Kristen F Shettleworth, PT
• Yeo Yang Shin, MD
• Alan Lee Siegel, D.D.S.
• Deborah Ruth Siegel, LCSW
• Beth Ann Sieling, MD
• Silver Belle Hair Co LLC

• Diagnostic Radiology Physician in Southbury, CT
• Providers in Southbury, CT by specialty
• Diagnostic Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.