Kalugotla N Shivaram, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

111383 Issued in MO

Practice address

1111 W Pearce Blvd
Wentzville, MO 63385-1020

Phone

(636) 887-4288

Fax

(636) 639-2368

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

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 2

Specialty

Emergency MedicineAlso: Pediatric Medicine

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Group practices

Southeastern Emergency Physicians of Memphis LLCGroup PAC ID 5395643209, 92 clinicians

Alton-Griffin Emergency Group PCGroup PAC ID 7315167103, 17 clinicians

Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Potosi Emergency Group, LLCGroup PAC ID 0648588541, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Anthony'S Health Center Hospital, Alton, IL, CCN 140052
• Parkland Health Center - Bonne Terre Hospital, Bonne Terre, MO, CCN 260779
• Washington County Memorial Hospital Hospital, Potosi, MO, CCN 261308

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

100

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

95

Improvement activities

40

Cost

80.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshivaram@yourcarecommunity.org
• Direct secure messaging: kshivaram134692@direct.carenet.org
• FHIR API: https://fhir-usa.unify.chbase.com/org/carlin-6115abf3

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.

• Potosi Emergency Group, LLC

  • Emergency Medicine Physician
  • Potosi, MO
  • NPI 1881075349
  Medicare reassignment Care Compare group NPD
• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment Care Compare group NPD
• Alton-Griffin Emergency Group PC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1891104824
  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment Care Compare group NPD
• Cep America, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1275970295
  Medicare reassignment NPD
• Texas County Memorial Hospital

  • General Acute Care Hospital
  • Houston, MO
  • NPI 1790740363

  Emergency Medicine

  Medicare reassignment NPD
• Carlinville Area Hospital Association

  • Critical Access Hospital
  • Carlinville, IL
  • NPI 1053425124
  Medicare reassignment NPD
• Carlinville Area Hospital Association

  • Critical Access Hospital
  • Carlinville, IL
  • NPI 1932275641
  Medicare reassignment NPD
• Sanburg Emergency Group, P.C.

  • Emergency Medicine Physician
  • Galesburg, IL
  • NPI 1992337000
  Medicare reassignment NPD
• Our Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wentzville, MO
  • NPI 1902815863
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1699461673
  NPD

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

• Parkland Health Center

  • Rural Acute Care Hospital
  • Bonne Terre, MO
  • NPI 1932117173
  Care Compare affiliation
• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1710396932
  Care Compare affiliation

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1619959137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 BELLERIVE MANOR DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631413201",
            "telephone_number": "636-887-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W PEARCE BLVD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851020",
            "telephone_number": "636-887-4288",
            "fax_number": "636-639-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVARAM",
        "first_name": "KALUGOTLA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036086751",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MO",
            "license": "111383",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "111383",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "111383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207245606",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086751",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Best, LLC
• Brett Shelton, PT, DPT
• Carol Shipley, PHARMD, BS
• Joshua Shipley, PHARMD, BS
• Daniel Shipp
• Rabia Shoaib, MED, PLPC
• Amber Shocklee, LPC
• Jeanne S Short, PNP
• John Paul Shoup, M.D.
• Charla Salmon Shurtleff, COTA/L

• Emergency Medicine Physician in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.