Shapan Debnath, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A16995 Issued in CA

Practice address

1220 S Central Ave Ste 105
Glendale, CA 91204-3808

Phone

(818) 545-9539

NPI assigned

Apr 28, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sheila Debnath M D IncGroup PAC ID 4284029687, 2 clinicians

Gracelight Community HealthGroup PAC ID 3072619618, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (4 of 5)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment Care Compare group NPD
• Sheila Debnath M D Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1952625303
  Medicare reassignment Care Compare group NPD
• Glendale Adventist Medical Center

  • Skilled Nursing Facility
  • Glendale, CA
  • NPI 1114916293
  NPD (past)
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1639241888
  NPD (past)

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1730614652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE STE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043808",
            "telephone_number": "818-545-9539",
            "fax_number": "818-545-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE STE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043808",
            "telephone_number": "818-545-9539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 4th St SW",
            "address_2": "Suite 340",
            "address_purpose": "LOCATION",
            "city": "Mason City",
            "state": "IA",
            "postal_code": "504012857",
            "country_code": "US",
            "telephone_number": "641-428-7766",
            "fax_number": "641-428-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBNATH",
        "first_name": "SHAPAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A16995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730614652",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan De Silva
• Crystal Deagueros
• Daisy Josselyn Deagueros
• Belamey Dean
• Deandrea a Medical Corporation
• Sheila Debnath, MD
• Brandi Alexandria Dechellis, LVN
• Keyla Decos, LCSW
• Hossein Dehghani, M.D.
• Ariel Ronquillo Dela Cruz, REGISTERED NURSE

• Family Medicine Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.