Active NPI
Shanthi Rajendran Physician PC
- Family Medicine Physician
- Akron, NY
National Provider Identifier
1619008869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 211182
- Legal business name
- SHANTHI RAJENDRAN PHYSICIAN PC
- Practice address
- 16 Main St
Akron, NY 14001-1220 - Phone
- (716) 542-9300
- NPI assigned
- Mar 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shanthi Rajendran, MD
- Title
- President
- Phone
- (716) 542-9300
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 211182 | NY | Primary |
Addresses
Primary practice location
16 Main St
Akron, NY 14001-1220
Mailing address
187 Viscount Dr
Williamsville, NY 14221-1771
Phone (716) 689-4587
Other names 1
- akron family care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101028000501 | NY | Part B Supplier - Clinic/Group Practice | 3577757145 |
Receives reassigned benefits from 6 practitioners Practice locations: Akron, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0984826 | Shanthi Rajendran Physician PC | Certificate of waiver | Mar 29, 2027 |
National Provider Directory
National Provider DirectoryLocations
16 Main St
Akron, NY 14001
Phone (716) 542-9300
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1421712000000",
"number": "1619008869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 VISCOUNT DR",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142211771",
"telephone_number": "716-689-4587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 MAIN ST",
"city": "AKRON",
"state": "NY",
"postal_code": "140011220",
"telephone_number": "716-542-9300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHANTHI RAJENDRAN PHYSICIAN PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-08",
"last_updated": "2015-01-20",
"status": "A",
"authorized_official_last_name": "RAJENDRAN",
"authorized_official_first_name": "SHANTHI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "716-542-9300",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NY",
"license": "211182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "akron family care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Akron, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.