Individual provider Active NPI

Santhra Shaji

  • Physician Assistant
  • Sunrise, FL
National Provider Identifier
1457079550
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3564 NW 95TH Ter
Sunrise, FL 33351-6467
Phone
(954) 830-2043
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3564 NW 95TH Ter
Sunrise, FL 33351-6467

Mailing address

3564 NW 95TH Ter
Sunrise, FL 33351-6467
Phone (954) 830-2043

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412000602 CA Practitioner - Physician Assistant 4981043767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1457079550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3564 NW 95TH TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516467",
            "telephone_number": "954-830-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3564 NW 95TH TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516467",
            "telephone_number": "954-830-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAJI",
        "first_name": "SANTHRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.