Individual provider Active NPI

Sharon Kshettry, MD

  • Obstetrics & Gynecology Physician
  • Bloomington, MN
National Provider Identifier
1508892209
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33696 Issued in MN
Practice address
7920 Old Cedar Ave S
Bloomington, MN 55425-1207
Phone
(951) 851-1000
Fax
(952) 851-1092
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33696 MN Primary

Addresses

Primary practice location

7920 Old Cedar Ave S
Bloomington, MN 55425-1207

Mailing address

1021 Bandana Blvd E
Suite 200
Saint Paul, MN 55108-5113
Phone (651) 642-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20070523000125 MN Practitioner - Obstetrics/Gynecology 5799882965

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Past Accepting new patients

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508892209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-642-2700",
            "fax_number": "651-641-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 OLD CEDAR AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251207",
            "telephone_number": "951-851-1000",
            "fax_number": "952-851-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KSHETTRY",
        "first_name": "SHARON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "33696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.