NPIMap

Individual provider Active NPI

Shubhra M Shetty, M.D.

  • Infectious Disease Physician
  • Scranton, PA
National Provider Identifier
1649264532
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD 059969L Issued in PA
Practice address
201 Franklin Ave Ste 3
Scranton, PA 18503-1947
Phone
(570) 800-7465
Fax
(570) 800-7474
NPI assigned
Sep 7, 2005
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD 059969L PA Primary

Addresses

Primary practice location

201 Franklin Ave Ste 3
Scranton, PA 18503-1947

Mailing address

201 Franklin Ave Ste 3
Scranton, PA 18503-1947
Phone (570) 800-7465

Other practice location 1

250 Old River Rd Ste C
Wilkes Barre, PA 18702-1611
Phone (570) 852-5875

Other identifiers 1

IdentifierTypeStateIssuer
1758578MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshetty@wvacinc.org.nextgen.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20061004000568 PA Practitioner - Internal MedicinePractitioner - Infectious Disease 5890791420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyoming Valley AIDS CouncilGroup PAC ID 8527398189, 2 clinicians

Practice addresses (Care Compare)

201 Franklin Ave
Suite 3
Scranton, PA 18503-1947
Phone (570) 800-7465

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 059969LPAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Valley AIDS Council Infectious Disease CurrentSince Dec 22, 2025 Accepting new patients
Scranton Primary Health Care Center, Inc. Current Accepting new patients
Intermountain Medical Group, Inc Past Accepting new patients

Locations

201 Franklin Ave
Ste 3
Scranton, PA 18503
Phone (570) 800-7465

425 Alder St
Scranton, PA 18505
Phone (570) 346-0759

959 Wyoming Ave
Scranton, PA 18509
Phone (570) 344-3517

250 Old River Rd
Ste C
Wilkes Barre, PA 18702
Phone (570) 826-5038

330 Bowman St
Unit 1
Wilkes Barre, PA 18702
Phone (570) 823-5808

Interoperability endpoints

  • Direct secure messaging: sshetty@wvac-pa.direct.office.nextgen.com

Organizations & group practices 3

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 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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1649264532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 FRANKLIN AVE STE 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031947",
            "telephone_number": "570-800-7465",
            "fax_number": "570-800-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 FRANKLIN AVE STE 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031947",
            "telephone_number": "570-800-7465",
            "fax_number": "570-800-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Old River Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187021611",
            "country_code": "US",
            "telephone_number": "570-852-5875",
            "fax_number": "570-852-5885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "SHUBHRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD 059969L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1758578",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshetty@wvacinc.org.nextgen.com",
            "affiliation": "N",
            "endpointDescription": "HISP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "201 Franklin Ave Ste 3",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185031947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.