Shanti Mangalasseril Shivaji, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

202002975 Issued in NC

Practice address

510 N Elam Ave Ste 101
Greensboro, NC 27403-1135

Phone

(336) 854-8800

Fax

(336) 834-0595

NPI assigned

Apr 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Obstetrics/Gynecology

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uwh of the Carolinas PLLCGroup PAC ID 0042448169, 329 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.25 of 100Reported as group

Quality

82.32

Promoting interoperability

100

Improvement activities

40

Cost

78.52

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanti.shivaji.1@7773.direct.athenahealth.com

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.

• Uwh of the Carolinas, PLLC

  • Obstetrics & Gynecology Physician
  • Morrisville, NC
  • NPI 1639506470
  Medicare reassignment Care Compare group NPD
• Whap, PA

  • Obstetrics & Gynecology Physician
  • Winston Salem, NC
  • NPI 1649261785
  NPD (past)

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1487018586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 BALDWIN DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221015048",
            "telephone_number": "703-442-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N ELAM AVE STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031135",
            "telephone_number": "336-854-8800",
            "fax_number": "336-834-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVAJI",
        "first_name": "SHANTI",
        "middle_name": "MANGALASSERIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "202002975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalub Gerrard Shipman Sr.
• Portia Lajoy Shipman
• James R Shipp, MA, LAT, ATC
• Vanita R Shipp, LPCA
• Dimitry Igorevich Shitarev, MD
• Kim Shoaf, RPH
• Shoals Family Therapy, P.C
• Shoe Market Samples Inc
• Jacqueline Shoe, RD, LDN
• Cameron B. Shoemaker

• Obstetrics & Gynecology Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.