Individual provider Active NPI

Shivjit Singh Gill, M.D.

  • Family Medicine Physician
  • League City, TX
National Provider Identifier
1639404551
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N3675 Issued in TX
Practice address
302 Highway 3 S
League City, TX 77573-3755
Phone
(281) 332-6573
NPI assigned
Oct 9, 2009
Last updated
Nov 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N3675 TX Primary

Addresses

Primary practice location

302 Highway 3 S
League City, TX 77573-3755

Mailing address

302 Highway 3 S
League City, TX 77573-3755
Phone (281) 332-6573

Other identifiers 1

IdentifierTypeStateIssuer
1639404551OtherTXNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100728000681 TX Practitioner - Family Practice 9931232980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villagemd of Southeast Texas PAGroup PAC ID 4587947346, 217 clinicians

Practice addresses (Care Compare)

302 Hwy 3 S
League City, TX 77573-3755
Phone (346) 646-4361

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Village Family Practice, L.L.P Family Medicine CurrentSince Jun 1, 2017 Accepting new patients
Villagemd of Southeast Texas, PA Family Medicine CurrentSince Jun 1, 2017 Accepting new patients

Locations

9055 Katy Fwy
Ste 100
Houston, TX 77024
Phone (346) 646-4954

9235 Katy Fwy
Ste 400
Houston, TX 77024
Phone (346) 980-2701

302 Highway 3 S
League City, TX 77573
Phone (281) 332-6573

Interoperability endpoints

  • Direct secure messaging: shivjit.gill.1@13711.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414972800000",
    "number": "1639404551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HIGHWAY 3 S",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733755",
            "telephone_number": "281-332-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 HIGHWAY 3 S",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733755",
            "telephone_number": "281-332-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "SHIVJIT",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-09",
        "last_updated": "2014-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N3675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1639404551",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.