Individual provider Active NPI

Shankar Mulloth Nandakumar, MD

  • Child & Adolescent Psychiatry Physician
  • Aurora, CO
National Provider Identifier
1477174084
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
DR.0073288 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
May 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0073288 CO
Child & Adolescent Psychiatry Physician 2084P0804X DR.0073288 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

1890 N Revere Ct Ste 4100
Aurora, CO 80045-7464
Phone (757) 282-8135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230727001478 TX Practitioner - Psychiatry 0042671729 Reassigns benefits to 1 organization
I20250905000759 CO Practitioner - PsychiatryPractitioner - Pediatric Medicine 0042671729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Pediatric Medicine
Education
University of Texas Medical School at San Antonio, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 110429
Aurora, CO 80042

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Current Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
University Physicians Incorporated CurrentSince Jul 1, 2025 Accepting new patients
University Physicians, Incorporated CurrentSince Jul 1, 2025 Accepting new patients
Psychiatry of Texas PLLC Psychiatry CurrentSince Jul 13, 2023 Accepting new patients

Locations

1890 N Revere Ct
Ste 4100
Aurora, CO 80045
Phone (303) 724-6018

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

7877 Willow Chase Blvd
Houston, TX 77070
Phone 8328694818109

902 Frostwood Dr
Ste 201
Houston, TX 77024
Phone (713) 932-7872

Interoperability endpoints

  • Direct secure messaging: snandakumar285782@direct.childrenscolorado.org

Organizations & group practices 5

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": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1477174084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 N Revere Ct Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457464",
            "country_code": "US",
            "telephone_number": "757-282-8135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NANDAKUMAR",
        "first_name": "SHANKAR",
        "middle_name": "MULLOTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0073288",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "DR.0073288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.