Organization Active NPI

Elevate Urology LLC

  • Urology Physician
  • Glastonbury, CT
National Provider Identifier
1710813233
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ELEVATE UROLOGY LLC
Practice address
730 Hebron Ave Ste 10
Glastonbury, CT 06033-5016
Phone
(860) 266-5550
Fax
(860) 266-5511
NPI assigned
Jun 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Shanta Shepherd, MDNPI 1174986756
Title
Owner
Phone
(860) 266-5550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

730 Hebron Ave Ste 10
Glastonbury, CT 06033-5016

Mailing address

730 Hebron Ave Ste 10
Glastonbury, CT 06033-5016
Phone (860) 266-5550

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1710813233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 HEBRON AVE STE 10",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060335016",
            "telephone_number": "860-266-5550",
            "fax_number": "860-266-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 HEBRON AVE STE 10",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060335016",
            "telephone_number": "860-266-5550",
            "fax_number": "860-266-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "SHANTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-266-5550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.