Shudipan Chakraborty

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Mercy St. Vincent Medical Center
2213 Cherry Street, Acc Building, 1St Floor Toledo, O
Toledo, OH 43608

Phone

(419) 251-4744

Fax

(419) 251-6795

NPI assigned

Jul 28, 2022

Last updated

Jul 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1417683756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 FRANKLIN AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201402",
            "telephone_number": "419-251-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MERCY ST. VINCENT MEDICAL CENTER",
            "address_2": "2213 CHERRY STREET, ACC BUILDING, 1ST FLOOR TOLEDO, O",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43608",
            "telephone_number": "419-251-4744",
            "fax_number": "419-251-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRABORTY",
        "first_name": "SHUDIPAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demareo Chafins
• Leon Victor Chagolla II, CRNA
• Bhupinder Singh Chahal, M.D.
• Nivene Chahine, PA-C
• Annapoorna Chakrabarty, MD
• Srinivasachari Tatadesika Chakravarthi, MD
• Jyoti Chakravarty, M.D.
• Supriya Chakravarty, MD
• Christopher Challenger
• Kaisa Chalmers

• Student in an Organized Health Care Education/Training Program in Toledo, OH
• Providers in Toledo, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.