Individual provider Active NPI

Shanti Bhatia

  • Pediatrics Physician
  • Woodburn, OR
National Provider Identifier
1790219590
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD198728 Issued in OR
Practice address
2050 Progress Way
Woodburn, OR 97071-9764
Phone
(503) 981-5348
NPI assigned
Apr 18, 2017
Last updated
Sep 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD198728 OR Primary

Addresses

Primary practice location

2050 Progress Way
Woodburn, OR 97071-9764

Mailing address

2050 Progress Way
Woodburn, OR 97071-9764
Phone (503) 981-5348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180531002951 AZ Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5991060576

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD198728ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodburn Pediatric Clinic PastSince Sep 13, 2020 Accepting new patients
Woodburn Pediatric Clinic LLP Pediatrics PastSince Sep 13, 2020 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: shanti.bhatia.wpc@direct.wvp.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1790219590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 PROGRESS WAY",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719764",
            "telephone_number": "503-981-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 PROGRESS WAY",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719764",
            "telephone_number": "503-981-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATIA",
        "first_name": "SHANTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD198728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.