Individual provider Active NPI

Shelly Chatterjee Choudhury, M.D.

  • Pediatric Gastroenterology Physician
  • Loma Linda, CA
National Provider Identifier
1871857227
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
A145691 Issued in CA
Practice address
25845 Barton Rd Ste F
Loma Linda, CA 92354
Phone
(909) 558-3904
NPI assigned
Jun 30, 2012
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A145691 CA
Pediatric Gastroenterology Physician 2080P0206X A145691 CA Primary

Addresses

Primary practice location

25845 Barton Rd Ste F
Loma Linda, CA 92354

Mailing address

File Number 54701
Los Angeles, CA 90074-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180830000503 CA Practitioner - GastroenterologyPractitioner - Pediatric Medicine 3375893092 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145691CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Pediatrics CurrentSince Oct 8, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Oct 8, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Oct 8, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Oct 8, 2021 Accepting new patients
University of California San Francisco CurrentSince Oct 8, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics CurrentSince Aug 1, 2018 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

3360 Geary Blvd
Ste 201
San Francisco, CA 94118
Phone (415) 353-3100

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: schoudhury179984@direct.llu.edu
  • Direct secure messaging: schoudhury196615@direct-ucsfmedicalcenter.org

Organizations & group practices 10

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": "1341014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1871857227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE NUMBER 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD STE F",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHURY",
        "first_name": "SHELLY",
        "middle_name": "CHATTERJEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A145691",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A145691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.