Individual provider Active NPI

Lakshmi Shukla, MD

  • Pulmonary Disease Physician
  • Costa Mesa, CA
National Provider Identifier
1407043243
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A33993 Issued in CA
Practice address
136 Broadway
Costa Mesa, CA 92627-2818
Phone
(949) 548-5111
NPI assigned
Sep 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A33993 CA Primary

Addresses

Primary practice location

136 Broadway
Costa Mesa, CA 92627-2818

Mailing address

P.O. Box 8500
Newport Beach, CA 92658-8500
Phone (949) 548-5111

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100730000734 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 2668505496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mesa Pulmonary Group IncGroup PAC ID 3476975087, 6 clinicians

Practice addresses (Care Compare)

136 Broadway
Costa Mesa, CA 92627-2818
Phone (949) 873-5537

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Strongkids Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients
Strongkids Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Mesa Pulmonary Group, Inc. Pulmonary Disease CurrentSince Oct 5, 2021 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Locations

136 Broadway
Costa Mesa, CA 92627
Phone (949) 288-5377

2222 S Main St
Santa Ana, CA 92707
Phone (714) 436-9999

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1407043243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8500",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926588500",
            "telephone_number": "949-548-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BROADWAY",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272818",
            "telephone_number": "949-548-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "LAKSHMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A33993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.