Organization Active NPI

Shashi D Ganti MD PC

  • Ophthalmology Physician
  • Fremont, CA
National Provider Identifier
1801287420
Registry record updated Sep 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A38830 Issued in CA
Legal business name
SHASHI D GANTI MD PC
Practice address
2147 Mowry Ave Ste D1
Fremont, CA 94538-1724
Phone
(510) 556-2153
Fax
(510) 556-2155
NPI assigned
Feb 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2024

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

Authorized official

Name
Dr. Shashi D Ganti, MDNPI 1023037215
Title
President/Ceo
Phone
(559) 433-5459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A38830 CA Primary

Addresses

Primary practice location

2147 Mowry Ave Ste D1
Fremont, CA 94538-1724

Mailing address

2147 Mowry Ave Ste D1
Fremont, CA 94538-1724
Phone (510) 556-2153

Other practice location 1

557 W Morton Ave Unit D
Porterville, CA 93257-3383
Phone (559) 433-5459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180524002384 CA Part B Supplier - Clinic/Group Practice 0648535534 Receives reassigned benefits from 1 practitioner
Practice locations: Fremont, CA; Porterville, CA

National Provider Directory

National Provider Directory

Locations

2147 Mowry Ave
Ste D1
Fremont, CA 94538
Phone (510) 556-2153

557 W Morton Ave
Unit D
Porterville, CA 93257
Phone (559) 433-5459

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGFCDA

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726963200000",
    "number": "1801287420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 MOWRY AVE STE D1",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381724",
            "telephone_number": "510-556-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 MOWRY AVE STE D1",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381724",
            "telephone_number": "510-556-2153",
            "fax_number": "510-556-2155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "557 W Morton Ave Unit D",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "932573383",
            "country_code": "US",
            "telephone_number": "559-433-5459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHASHI D GANTI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-18",
        "last_updated": "2024-09-22",
        "certification_date": "2024-09-22",
        "status": "A",
        "authorized_official_last_name": "GANTI",
        "authorized_official_first_name": "SHASHI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "559-433-5459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A38830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.