Vidya Shankaran, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036134925 Issued in IL

Practice address

340 W Lincoln St
Ste 500
Belleville, IL 62220-1900

Phone

(618) 277-7400

NPI assigned

Aug 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: vshankaran383761@direct.dartmouth-hitchcock.org

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.

• Lincoln Surgical Group

  • Surgery Physician
  • Belleville, IL
  • NPI 1700962271
  NPD (past)

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1528214624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W LINCOLN ST",
            "address_2": "STE 500",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201900",
            "telephone_number": "618-277-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W LINCOLN ST",
            "address_2": "STE 500",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201900",
            "telephone_number": "618-277-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKARAN",
        "first_name": "VIDYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NH",
            "license": "20106",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125050724",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036134925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "036134925",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan T Shah, OT
• Niraj J Shah, M.D.
• Parvish Pradip Shah, DO
• Erum Ahad Shaikh, M.D.
• Madeline Rose Shane
• Farah Sharieh, MD
• Anuj Sharma, M.D.
• Ruchi Sharma, BCBA (LICENSED, IL)
• Bushra Shaukat, MD
• Hannah Taylor Shaw, M.S. CCC-SLP

• Plastic Surgery Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.