NPIMap

Individual provider Active NPI

Vikram Sai Shivaji, M.D.

  • Body Imaging Physician
  • Winston Salem, NC
National Provider Identifier
1770947822
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
2021-00646 Issued in NC
Practice address
Wake Forest Baptist Medical Center Medical Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-4305
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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
Body Imaging Physician 2085B0100X 2021-00646 NC Primary

Addresses

Primary practice location

Wake Forest Baptist Medical Center Medical Blvd
Winston Salem, NC 27157-0001

Mailing address

Wake Forest Baptist Medical Center Medical Blvd
Winston Salem, NC 27157-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210616001496 NC Practitioner - Diagnostic Radiology 3072806959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096
  • Alleghany Memorial Hospital Hospital, Sparta, NC, CCN 341320
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Hugh Chatham Memorial Hospital Hospital, Elkin, NC, CCN 340097
  • Wilkes Regional Medical Center Hospital, North Wilkesboro, NC, CCN 340064

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Baptist Imaging LLC CurrentSince Sep 27, 2024 Accepting new patients
Wake Forest Baptist Imaging, LLC CurrentSince Jul 1, 2021 Accepting new patients
Wake Forest Baptist Imaging, LLC CurrentSince Jul 1, 2021 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jun 9, 2021 Accepting new patients

Locations

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: vshivaji2754121@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1770947822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVAJI",
        "first_name": "VIKRAM",
        "middle_name": "SAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NC",
            "license": "2021-00646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.