Individual provider Active NPI

Vishal Shetty, MD

  • Emergency Medicine Physician
  • Dover, DE
National Provider Identifier
1720708829
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C70018248 Issued in DE
Practice address
640 S State St
Dover, DE 19901-3530
Phone
(302) 554-3300
NPI assigned
Aug 30, 2022
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 16375-I PR
Emergency Medicine Physician 207P00000X C70018248 DE Primary

Addresses

Primary practice location

640 S State St
Dover, DE 19901-3530

Mailing address

5803 Calle Tartak Apt 906
Carolina, PR 00979-5603
Phone (917) 946-4049

Other practice location 1

Carr. 844
Rio Piedras, PR 00928
Phone (787) 653-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20230614000101 DE Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 6305204900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C70018248DEMDEmergency Medicine Physician
16375-IPRMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1720708829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 CALLE TARTAK APT 906",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009795603",
            "telephone_number": "917-946-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-554-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr. 844",
            "address_purpose": "LOCATION",
            "city": "Rio Piedras",
            "state": "PR",
            "postal_code": "00928",
            "country_code": "US",
            "telephone_number": "787-653-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "VISHAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "16375-I",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C70018248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.