Active NPI
Prateek Shukla, MD
- Pediatric Pulmonology Physician
- Washington, DC
National Provider Identifier
1841601986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- MTL002120
- Practice address
- 111 Michigan Ave NW
Pulmonary Department
Washington, DC 20010-2916 - Phone
- (202) 476-6399
- NPI assigned
- May 12, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 363439 | ZZ | |
| Pediatric Pulmonology Physician | 2080P0214X | MTL002120 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Pulmonary Department
Washington, DC 20010-2916
Mailing address
1413 K St SE
Washington, DC 20003-3235
Phone (650) 696-0868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 363439 | ZZ | MD | Pediatrics Physician |
| MTL002120 | DC | MD | Pediatric Pulmonology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404777600000",
"number": "1841601986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1413 K ST SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200033235",
"telephone_number": "650-696-0868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"address_2": "PULMONARY DEPARTMENT",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "202-476-6399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKLA",
"first_name": "PRATEEK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-12",
"last_updated": "2014-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ZZ",
"license": "363439",
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "DC",
"license": "MTL002120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.