Organization Active NPI

Shivhanuman Medical PC

  • Primary Care Clinic/Center
  • Bronx, NY
National Provider Identifier
1619055092
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
210008 Issued in NY
Legal business name
SHIVHANUMAN MEDICAL PC
Practice address
405 E 187TH St
Bronx, NY 10458-5705
Phone
(718) 365-7770
Fax
(718) 365-7777
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Akxay Shashikant Patel, D.O.NPI 1841368222
Title
President
Phone
(718) 365-7770

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)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 210008 NY Primary

Addresses

Primary practice location

405 E 187TH St
Bronx, NY 10458-5705

Mailing address

405 E 187TH St
Bronx, NY 10458-5705
Phone (718) 365-7770

Other identifiers 1

IdentifierTypeStateIssuer
01970350MedicaidNY

National Provider Directory

National Provider Directory

Locations

405 E 187th St
Bronx, NY 10458
Phone (718) 365-7770

Practitioners & affiliated clinicians

Practitioners 1

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619055092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E 187TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585705",
            "telephone_number": "718-365-7770",
            "fax_number": "718-365-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E 187TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585705",
            "telephone_number": "718-365-7770",
            "fax_number": "718-365-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIVHANUMAN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AKXAY",
        "authorized_official_middle_name": "SHASHIKANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-365-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "210008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01970350",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.