NPIMap

Individual provider Active NPI

Joshan K Shajan, M.D.

  • Internal Medicine Physician
  • Cos Cob, CT
National Provider Identifier
1790043040
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53782 Issued in CT
Practice address
40 E Putnam Ave Ste 1B
Cos Cob, CT 06807-2606
Phone
(203) 489-5442
Fax
(203) 325-3270
NPI assigned
Apr 24, 2012
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A155675 CA
Internal Medicine Physician 207R00000X 53782 CT Primary

Addresses

Primary practice location

40 E Putnam Ave Ste 1B
Cos Cob, CT 06807-2606

Mailing address

212 Bible St
Cos Cob, CT 06807-1322
Phone (646) 652-1791

Other practice location 1

3863 Clairemont Dr
San Diego, CA 92117-5831
Phone (858) 483-5570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150406001079 CT Practitioner - Internal Medicine 9638497571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

90 Morgan St
Suite 103
Stamford, CT 06905-5436
Phone (203) 978-3138

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155675CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Office & Walk in Clinic Ca Inc General Practice CurrentSince Jan 29, 2023 Accepting new patients

Locations

3863 Clairemont Dr
San Diego, CA 92117
Phone (858) 483-5570

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: joshan.shajan.1@29110.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1790043040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 BIBLE ST",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068071322",
            "telephone_number": "646-652-1791",
            "fax_number": "888-981-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E PUTNAM AVE STE 1B",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072606",
            "telephone_number": "203-489-5442",
            "fax_number": "203-325-3270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3863 Clairemont Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921175831",
            "country_code": "US",
            "telephone_number": "858-483-5570",
            "fax_number": "858-483-5572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAJAN",
        "first_name": "JOSHAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A155675",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "53782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cos Cob, CT

Sources for this page

Verify at the official NPI Registry.