NPIMap

Individual provider Active NPI

Shalini Rao Kanneganti, M.D

  • Colon & Rectal Surgery Physician
  • Tacoma, WA
National Provider Identifier
1639326192
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD60297035 Issued in WA
Practice address
3315 S 23Rd St
Ste 200
Tacoma, WA 98405-1605
Phone
(253) 552-1200
Fax
(253) 552-1239
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 70957 AZ
Surgery Physician 208600000X MD60297035 WA
Colon & Rectal Surgery Physician 208C00000X MD60297035 WA Primary

Addresses

Primary practice location

3315 S 23Rd St
Ste 200
Tacoma, WA 98405-1605

Mailing address

3315 S 23Rd St
Ste 200
Tacoma, WA 98405-1605
Phone (253) 552-1200

Other identifiers 2

IdentifierTypeStateIssuer
0299319OtherWASTATE L&I
0299812OtherWASTATE L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121025000524 WA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 4385894443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
Tacoma, WA 98405-4930

1617 S J St
Tacoma, WA 98405-4930
Phone (253) 426-6306

1708 Yakima Ave
Tacoma, WA 98405-5307
Phone (253) 272-2224

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
70957AZMDSurgery Physician
MD60297035WAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Sep 1, 2012 Accepting new patients
Franciscan Medical Group Surgery CurrentSince Sep 1, 2012 Accepting new patients
Franciscan Health System Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

3315 S 23rd St
Ste 200
Tacoma, WA 98405
Phone (206) 572-8326

1708 Yakima Ave
Ste 105
Tacoma, WA 98405
Phone (253) 426-4420

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: skanneganti8667@fhsce.catholichealth.net

Organizations & group practices 5

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 10

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1639326192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 S 23RD ST",
            "address_2": "STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051605",
            "telephone_number": "253-552-1200",
            "fax_number": "253-552-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 S 23RD ST",
            "address_2": "STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051605",
            "telephone_number": "253-552-1200",
            "fax_number": "253-552-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNEGANTI",
        "first_name": "SHALINI",
        "middle_name": "RAO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "70957",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60297035",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WA",
            "license": "MD60297035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0299319",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0299812",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.