Individual provider Active NPI

Shalini Boyapati, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1770638173
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D65616 Issued in MD
Practice address
Fort Worth VA Clinic
2201 Southeast Loop 820
Fort Worth, TX 76119
Phone
(817) 730-0000
Fax
(817) 730-0601
NPI assigned
Jan 24, 2007
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T1021 TX
Internal Medicine Physician 207R00000X P18627 MD
Internal Medicine Physician 207R00000X D65616 MD Primary

Addresses

Primary practice location

Fort Worth VA Clinic
2201 Southeast Loop 820
Fort Worth, TX 76119

Mailing address

2401 W Belvedere Ave
Dept. of Credentialing
Baltimore, MD 21215-5216
Phone (410) 601-5524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180423002220 MD Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4789777285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D65616MDMDInternal Medicine Physician
P18627MDMDInternal Medicine Physician
T1021TXMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1770638173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "DEPT. OF CREDENTIALING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-5524",
            "fax_number": "410-601-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FORT WORTH VA CLINIC",
            "address_2": "2201 SOUTHEAST LOOP 820",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76119",
            "telephone_number": "817-730-0000",
            "fax_number": "817-730-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYAPATI",
        "first_name": "SHALINI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-07-20",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T1021",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "P18627",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D65616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.