Individual provider Active NPI

Rahul Rangrao Shinde, P.A

  • Surgical Physician Assistant
  • Oswego, NY
National Provider Identifier
1619416203
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
020485 Issued in NY
Practice address
140 W 6TH St
Oswego, NY 13126-2525
Phone
(315) 349-5873
Fax
(315) 349-5874
NPI assigned
Feb 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 020485 NY Primary

Addresses

Primary practice location

140 W 6TH St
Oswego, NY 13126-2525

Mailing address

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170414000304 NY Practitioner - Physician Assistant 3870879489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Care PCGroup PAC ID 9032367453, 74 clinicians

Practice addresses (Care Compare)

110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5511

Hospital & facility affiliations

  • Oswego Hospital Hospital, Oswego, NY, CCN 330218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greece Dermatological Associates, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rshinde@oswegohealth.hiemail.healtheconnections.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1619416203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262507",
            "telephone_number": "315-349-5873",
            "fax_number": "315-349-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W 6TH ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262525",
            "telephone_number": "315-349-5873",
            "fax_number": "315-349-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDE",
        "first_name": "RAHUL",
        "middle_name": "RANGRAO",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "020485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.