Individual provider Active NPI

Tirunellai Ranganathan Shankar, MD

  • Surgery Physician
  • Skowhegan, ME
National Provider Identifier
1780700856
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD17663 Issued in ME
Practice address
46 Fairview Ave Ste 223
Skowhegan, ME 04976-1481
Phone
(207) 474-7045
Fax
(207) 474-5173
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD17663 ME Primary

Addresses

Primary practice location

46 Fairview Ave Ste 223
Skowhegan, ME 04976-1481

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 474-7045

Other identifiers 2

IdentifierTypeStateIssuer
1780700856MedicaidME
000468201OtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20080321000051 ME Practitioner - General Surgery 2567548209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Nevada School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redington-Fairview General HospitalGroup PAC ID 9133018740, 50 clinicians

Practice addresses (Care Compare)

46 Fairview Ave
Suite 223
Skowhegan, ME 04976-1481
Phone (207) 474-7045

Hospital & facility affiliations

  • Redington Fairview General Hospital Hospital, Skowhegan, ME, CCN 201314

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince Feb 20, 2008 Accepting new patients
Redington-Fairview General Hospital CurrentSince Feb 20, 2008 Accepting new patients

Locations

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

46 Fairview Ave
Ste 113
Skowhegan, ME 04976
Phone (207) 474-3697

46 Fairview Ave
Ste 223
Skowhegan, ME 04976
Phone (207) 474-7045

Interoperability endpoints

  • Direct secure messaging: tirunellai.shankar@rgs.direct.rfgh.net

Organizations & group practices 2

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 1

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1780700856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-474-7045",
            "fax_number": "207-474-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE STE 223",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-7045",
            "fax_number": "207-474-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKAR",
        "first_name": "TIRUNELLAI",
        "middle_name": "RANGANATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD17663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780700856",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000468201",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.