Deepak A Shivaram, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A62177 Issued in CA

Practice address

44215 15TH St W Ste 111
Lancaster, CA 93534-5503

Phone

(661) 949-5941

Fax

(661) 949-5871

NPI assigned

Oct 31, 2005

Last updated

Feb 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  NPD (past)
• Kenneth V. Miselis, M.D. Inc.

  dba Heritage Eye Associates

  • Specialist
  • Stockton, CA
  • NPI 1962413740
  NPD (past)
• Lancaster Hospital Corporation

  dba Palmdale Regional Medical Center

  • Rehabilitation Hospital Unit
  • Palmdale, CA
  • NPI 1033109947
  NPD (past)

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

• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  Care Compare affiliation

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1588655450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W",
            "address_2": "STE. 111",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344014",
            "telephone_number": "661-949-5941",
            "fax_number": "661-949-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W STE 111",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935345503",
            "telephone_number": "661-949-5941",
            "fax_number": "661-949-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVARAM",
        "first_name": "DEEPAK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A621770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "331042573",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michiko Shimizu
• Elizabeth Jayne Shimoi, CERTIFIED OCCUPATION
• Esther Shimokochi, LVN
• Chloe Y. Shin
• Shirazi Dental One a Professional Corporation (Eagle Dental)
• Jessica Shlager, OTR
• Svetlana Shnaider, NP
• Kristina Rosemarie Shoemaker
• Corinna Shoji, RPH
• Racquel Elizabeth Shores, CASE MANAGER

• Internal Medicine Physician in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.