Active NPI
Sushrut Vinod Shidham, MD
- Anesthesiology Physician
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- Q3595
- Practice address
- 12222 Merit Dr Ste 600
Dallas, TX 75251-3294 - Phone
- (972) 715-5000
- Fax
- (972) 715-9976
- NPI assigned
- May 31, 2011
- Last updated
- Jul 27, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Q3595 | TX | Primary |
Addresses
Primary practice location
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Mailing address
PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999
Other practice location 1
6606 Lyndon B Johnson Fwy Ste 200
Dallas, TX 75240-6524
Phone (972) 233-1999
Other practice location 2
4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-4000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8FY063 | Other | TX | BCBS |
| 357138201 | Medicaid | TX | |
| 357138203 | Medicaid | TX | |
| 357138204 | Other | TX | CSHCN |
| P01654506 | Other | TX | RR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Medical College of Wisconsin, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
900 8TH Ave
Fort Worth, TX 76104-3902
Phone (817) 347-5859
Hospital & facility affiliations
- Methodist Mansfield Medical Center
- Texas Health Heart & Vascular Hospital Arlington
- Methodist Midlothian Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.94 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U. S. Anesthesia Partners of Texas, P.a., | Anesthesiology | Current | Accepting new patients |
| U S Anesthesia Partners of Texas, PA | Anesthesiology | Current | Accepting new patients |
Locations
811 Wright St
Arlington, TX 76012
Phone (817) 960-3500
12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844
6606 Lyndon B Johnson Fwy
Ste 200
Dallas, TX 75240
Phone (469) 364-4109
900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100
1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600
7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000
100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555
9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300
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.
-
dba Greater Houston Anesthesiology, P.A.
- Anesthesiology Physician
- Houston, TX
- NPI 1548208564
-
- Interventional Pain Medicine Physician
- Addison, TX
- NPI 1053800391
Anesthesiology
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Texas Health Heart & Vascular Hospital Arlington
- Special Hospital
- Arlington, TX
- NPI 1407169196
-
dba Methodist Midlothian Medical Center
- General Acute Care Hospital
- Midlothian, TX
- NPI 1487271375
-
dba Methodist Mansfield Medical Center
- General Acute Care Hospital
- Mansfield, TX
- NPI 1689629941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1801180500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840853",
"city": "DALLAS",
"state": "TX",
"postal_code": "752840853",
"telephone_number": "972-233-1999",
"fax_number": "972-233-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12222 MERIT DR STE 600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752513294",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976"
}
],
"practiceLocations": [
{
"address_1": "6606 Lyndon B Johnson Fwy Ste 200",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752406524",
"country_code": "US",
"telephone_number": "972-233-1999",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4502 Medical Dr",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "78229",
"country_code": "US",
"telephone_number": "210-358-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIDHAM",
"first_name": "SUSHRUT",
"middle_name": "VINOD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-31",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "Q3595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8FY063",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "357138201",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "357138203",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "357138204",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR",
"identifier": "P01654506",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.