Individual provider Active NPI

Carol Marie Shetty, MD

  • Family Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1841816667
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301509577 Issued in MI
Practice address
1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone
(734) 539-5000
NPI assigned
Jun 17, 2020
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351046112 MI
Family Medicine Physician 207Q00000X 4301509577 MI Primary

Addresses

Primary practice location

1801 Briarwood Cir
Ann Arbor, MI 48108-3347

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

200 Arnet St Ste 200
Ypsilanti, MI 48198-5753
Phone (734) 482-6221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231114001149 MI Practitioner - Family Practice 2466875539 Reassigns benefits to 1 organization
I20241108000947 MD Practitioner - Family Practice 2466875539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

29 S Paca St
Baltimore, MD 21201-1771
Phone (667) 214-2100

5890 Waterloo Rd
Columbia, MD 21045-2617
Phone (667) 214-2100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509577MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Family Medicine Associates, P.a. Current Accepting new patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Sep 16, 2024 Accepting new patients
Regents of the University of Michigan Family Medicine CurrentSince Oct 10, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Oct 10, 2023 Accepting new patients
University of Maryland Faculty Physicians Immediate Care, LLC CurrentSince Sep 16, 2024 Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients

Locations

250 W Pratt St
Ste 900
Baltimore, MD 21201
Phone (410) 328-6267

5890 Waterloo Rd
Columbia, MD 21045
Phone (410) 328-2603

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

14700 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-1321

200 Arnet St
Ste 200
Ypsilanti, MI 48198
Phone (734) 482-6221

Interoperability endpoints

  • Direct secure messaging: cshetty1176046@direct.umm.edu

Organizations & group practices 6

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 1

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1841816667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BRIARWOOD CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083347",
            "telephone_number": "734-539-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Arnet St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481985753",
            "country_code": "US",
            "telephone_number": "734-482-6221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "CAROL",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351046112",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301509577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.