NPIMap

Individual provider Active NPI

Shankha Nandi, D.O.

  • Nephrology Physician
  • Wildomar, CA
National Provider Identifier
1437326410
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A10347 Issued in CA
Practice address
36320 Inland Valley Dr
Suite 308
Wildomar, CA 92595-7512
Phone
(951) 600-7630
Fax
(951) 600-7164
NPI assigned
May 9, 2008
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A10347 CA Primary

Addresses

Primary practice location

36320 Inland Valley Dr
Suite 308
Wildomar, CA 92595-7512

Mailing address

3660 Park Sierra Dr Ste 203
Riverside, CA 92505-3071
Phone (951) 687-3400

Other practice location 1

31537 Rancho Pueblo Rd Ste 201
Temecula, CA 92592-4841
Phone (951) 687-7140

Other practice location 2

591 E Elder St Ste C
Fallbrook, CA 92028-5001
Phone (951) 687-7140

Other identifiers 1

IdentifierTypeStateIssuer
1437326410MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131125000089 CA Practitioner - Nephrology 1052479391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates Medical Group IncGroup PAC ID 5092604447, 64 clinicians

Practice addresses (Care Compare)

36320 Inland Valley Dr
Suite 307
Wildomar, CA 92595-7512
Phone (951) 600-7630

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10347CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates Medical Group Inc Nephrology CurrentSince Aug 1, 2013 Accepting new patients
Nephrology Associates Medical Group, Inc. PastSince Aug 8, 2021 Accepting new patients
Primecare Medical Group Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Rajeev Prasad MD PC Past Accepting new patients
Menifee Valley Medical Center Past Accepting new patients

Locations

591 E Elder St
Ste C
Fallbrook, CA 92028
Phone (760) 731-8989

3660 Park Sierra Dr
Ste 203
Riverside, CA 92505
Phone (951) 687-3400

3660 Park Sierra Dr
Ste 208
Riverside, CA 92505
Phone (951) 687-2800

31537 Rancho Pueblo Rd
Ste 201
Temecula, CA 92592
Phone (951) 687-7140

36320 Inland Valley Dr
Ste 307
Wildomar, CA 92595
Phone (909) 600-0110

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: shankha.nandi.1@19859.direct.athenahealth.com
  • Direct secure messaging: snandi182054@direct.llu.edu

Organizations & group practices 9

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.

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": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1437326410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053071",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR",
            "address_2": "SUITE 308",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-600-7630",
            "fax_number": "951-600-7164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31537 Rancho Pueblo Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925924841",
            "country_code": "US",
            "telephone_number": "951-687-7140",
            "fax_number": "951-303-3565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "591 E Elder St Ste C",
            "address_purpose": "LOCATION",
            "city": "Fallbrook",
            "state": "CA",
            "postal_code": "920285001",
            "country_code": "US",
            "telephone_number": "951-687-7140",
            "fax_number": "951-303-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NANDI",
        "first_name": "SHANKHA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A10347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437326410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.