Shishir A Dhruva, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A43275 Issued in CA

Practice address

1335 Buenaventura Blvd
Suite 100
Redding, CA 96001-0160

Phone

(530) 247-7246

Fax

(530) 245-0849

NPI assigned

Mar 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Shishir A Dhruva Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Therapeutic Pain Management Medical Clinic

  • Pain Medicine Physician
  • Redding, CA
  • NPI 1720295249
  NPD

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629045125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 BUENAVENTURA BLVD",
            "address_2": "STE 100",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010160",
            "telephone_number": "530-247-7246",
            "fax_number": "530-245-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 BUENAVENTURA BLVD",
            "address_2": "SUITE 100",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010160",
            "telephone_number": "530-247-7246",
            "fax_number": "530-245-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHRUVA",
        "first_name": "SHISHIR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A43275",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A43275",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "A043275",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0055650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHISHIR",
            "last_name": "DHRUVA",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Interventional Pain Medicine Physician in Redding, CA
• Providers in Redding, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.