Individual provider Active NPI

Shanmugapriya Dakshnamoorthy, M.D

  • Developmental - Behavioral Pediatrics Physician
  • Eugene, OR
National Provider Identifier
1568070993
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
MD227905 Issued in OR
Practice address
74B Centennial Loop
Eugene, OR 97401-7918
Phone
(503) 346-1640
Fax
(503) 346-6918
NPI assigned
Jul 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X MD227905 OR Primary

Addresses

Primary practice location

74B Centennial Loop
Eugene, OR 97401-7918

Mailing address

74B Centennial Loop
Eugene, OR 97401-7918
Phone (503) 346-1640

Other practice location 1

4801 Alberta Avenue
El Paso, TX 79905
Phone (915) 215-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20260619001036 OR Practitioner - Pediatric Medicine 0648614610

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 SW 5TH Ave
FL 5
Portland, OR 97201-5509

3740 Vinton Ave
Apt 203
Los Angeles, CA 90034-5783

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1568070993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74B CENTENNIAL LOOP",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017918",
            "telephone_number": "503-346-1640",
            "fax_number": "503-346-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74B CENTENNIAL LOOP",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017918",
            "telephone_number": "503-346-1640",
            "fax_number": "503-346-6918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Avenue",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79905",
            "country_code": "US",
            "telephone_number": "915-215-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAKSHNAMOORTHY",
        "first_name": "SHANMUGAPRIYA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OR",
            "license": "MD227905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.