Individual provider Active NPI

Shankho Shuvro Ganguli, M.D.

  • Interventional Cardiology Physician
  • Paducah, KY
National Provider Identifier
1407122989
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
TP684 Issued in KY
Practice address
1532 Lone Oak Rd Ste 415
Paducah, KY 42003-7943
Phone
(270) 442-0103
NPI assigned
Mar 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X TP684 KY Primary

Addresses

Primary practice location

1532 Lone Oak Rd Ste 415
Paducah, KY 42003-7943

Mailing address

1532 Lone Oak Rd Ste 415
Paducah, KY 42003-7943
Phone (270) 442-0103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200729002519 TN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0749563054
I20200903000035 MS Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 0749563054 Reassigns benefits to 1 organization
I20250211001027 KY Practitioner - Interventional Cardiology 0749563054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Tennessee, HSC, College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

1532 Lone Oak Rd
Suite 415
Paducah, KY 42003-7943
Phone (270) 442-0103

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting32
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC Cardiovascular Disease CurrentSince Jan 24, 2025 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Jan 24, 2025 Accepting new patients
Mercy Health Physicians Kentucky LLC Cardiovascular Disease Past Accepting new patients

Locations

1532 Lone Oak Rd
Ste 415
Paducah, KY 42003

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

1530 Lone Oak Rd
Ste 415
Paducah, KY 42003

Interoperability endpoints

  • Direct secure messaging: shankhoganguli@stern.allscriptsdirect.net
  • Direct secure messaging: sganguli32943@mlh.direct-ci.com
  • Direct secure messaging: sganguli2739838@direct.bsmhealth.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.

Hospital & facility affiliations 6

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1407122989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD STE 415",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037943",
            "telephone_number": "270-442-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD STE 415",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037943",
            "telephone_number": "270-442-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGULI",
        "first_name": "SHANKHO",
        "middle_name": "SHUVRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "TP684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.