Kavitha Shashikumar, M.D.

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

100265 Issued in GA

Practice address

6528 Saucon Valley Dr
Fort Worth, TX 76132-5452

Phone

(817) 819-4919

NPI assigned

Sep 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND, GA, ID3 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 3

Specialty

Infectious Disease

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
• St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score

89.63 of 100Reported as group

Quality

89.39

Promoting interoperability

100

Improvement activities

40

Cost

76.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• Sanford Bismarck

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Sanford Bismarck

  • Multi-Specialty Clinic/Center
  • Dickinson, ND
  • NPI 1720075377
  NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Digestive Health Associates of Texas, P.a.

  • Gastroenterology Physician
  • Dallas, TX
  • NPI 1831158310
  NPD (past)
• Meridian Infectious Disease Consultants, PLLC

  • Infectious Disease Physician
  • Fort Worth, TX
  • NPI 1154992170
  NPD (past)
• Mukhtar Anees M.D. P.a.

  • Specialist
  • Burleson, TX
  • NPI 1356398762
  NPD (past)
• Steven B Sotman, MD PA

  • Infectious Disease Physician
  • Fort Worth, TX
  • NPI 1962446294
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes West LTD

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1497858435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16387",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761620387",
            "telephone_number": "817-294-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6528 SAUCON VALLEY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761325452",
            "telephone_number": "817-819-4919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Vernon Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302404143",
            "country_code": "US",
            "telephone_number": "706-803-8010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHASHIKUMAR",
        "first_name": "KAVITHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "100265",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L5558",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "GA",
            "license": "100265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154604602",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshashikumar584286@directwellstar.org",
            "affiliation": "N",
            "address_1": "1600 Vernon Rd Ste G",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abigail Sharp
• Monique Sharp
• Nicole Helena Sharp, D.C.
• Gordon Patterson Sharratt, D.O.
• Laura E Sharratt, DO
• David Nathan Shau, MD
• Elizabeth Shaver
• Kasey Shaw Salyer, LCSW
• Aaron Ivy Shaw, DO
• Candice Tyan Shaw, OT, BCBA

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.