Individual provider Active NPI

Shashank Jolly, M.D

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Modesto, CA
National Provider Identifier
1902047814
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
01081142A Issued in IN
Practice address
1541 Florida Ave Ste 305
Modesto, CA 95350-4439
Phone
(209) 755-8335
Fax
(209) 575-5836
NPI assigned
Mar 23, 2009
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A126261 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01081142A IN Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD430577 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 11204 ND

Addresses

Primary practice location

1541 Florida Ave Ste 305
Modesto, CA 95350-4439

Mailing address

120 Victoria PL
Danville, CA 94506-1424
Phone (440) 655-7507

Other identifiers 2

IdentifierTypeStateIssuer
A126261OtherCASTATE LICENSE
1902047814MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IN, NE, IA, AZ, KS, CO, VA, OH9 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 9

Enrollment IDStateProvider typePAC IDDetails
I20140307000197 CA Practitioner - Cardiac SurgeryPractitioner - Other (Physician)Practitioner - General SurgeryPractitioner - Thoracic Surgery 3779634522 Reassigns benefits to 3 organizations
Practice locations: Fremont, CA
I20190405000681 IN Practitioner - Thoracic Surgery 3779634522 Reassigns benefits to 2 organizations
I20220818001509 NE Practitioner - Thoracic Surgery 3779634522 Reassigns benefits to 1 organization
I20230403000426 IA Practitioner - Thoracic Surgery 3779634522
I20230410001315 AZ Practitioner - Thoracic Surgery 3779634522 Reassigns benefits to 1 organization
I20241115003014 KS Practitioner - Thoracic SurgeryPractitioner - Cardiovascular Disease (Cardiology) 3779634522 Reassigns benefits to 1 organization
I20241206000371 CO Practitioner - Thoracic Surgery 3779634522 Reassigns benefits to 2 organizations
I20250804003337 VA Practitioner - Thoracic Surgery 3779634522 Reassigns benefits to 2 organizations
I20251217004028 OH Practitioner - Cardiovascular Disease (Cardiology) 3779634522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians
First Choice Physician PartnersGroup PAC ID 0941465322, 130 clinicians
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

1541 Florida Ave
Suite 305
Modesto, CA 95350-4439
Phone (209) 577-3388

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222

8075 N Shadeland Ave
Suite 200
Indianapolis, IN 46250-2694
Phone (317) 621-8500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126261CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD430577PAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital, Inc. Family Medicine Current Accepting new patients
RMH Medical Group LLC CurrentSince May 22, 2025 Accepting new patients
First Choice Physician Partners CurrentSince Aug 24, 2023 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Oct 9, 2025 Accepting new patients
Poudre Valley Medical Group, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
CHI Health Clinic Specialty, LLC Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Kaweah Delta Health Care District CurrentSince Jan 17, 2022 Accepting new patients
Washington Township Medical Foundation Family Medicine CurrentSince Jan 5, 2014 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Family Medicine Current Accepting new patients
Poudre Valley Medical Group, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 1, 2025 Accepting new patients
Kaweah Delta Health Care District CurrentSince Jan 17, 2022 Accepting new patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince Jan 1, 2026 Accepting new patients
Community Physician Network Specialty Care LLC CurrentSince Dec 1, 2025 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 27, 2024 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Jan 15, 2024 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Oct 9, 2025 Accepting new patients
Washington Township Medical Foundation CurrentSince Jan 5, 2014 Accepting new patients
RMH Medical Group LLC CurrentSince May 22, 2025 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 27, 2024 Accepting new patients
TMC Medical Network CurrentSince Apr 5, 2023 Accepting new patients
Topeka Physician Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
Topeka Physician Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
First Choice Physician Partners CurrentSince Aug 24, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 15, 2024 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients
First Choice Physician Partners Family Medicine Past Accepting new patients

Locations (25 of 33)

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

39141 Civic Center Dr
Ste 335
Fremont, CA 94538
Phone (510) 248-1400

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839

1541 Florida Ave
Ste 305
Modesto, CA 95350
Phone (209) 575-5833

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

505 W Main St
Ste B
Visalia, CA 93291
Phone (559) 627-6149

840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2643 Patterson Rd
Ste 403
Grand Junction, CO 81506
Phone (970) 298-7662

1600 N Grand Ave
Ste 500
Pueblo, CO 81003
Phone (719) 545-0663

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

5819 Reliable Pkwy
Chicago, IL 60686

5918 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

8075 N Shadeland Ave
Ste 200
Indianapolis, IN 46250
Phone (317) 621-8000

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

1700 SW 7th St
Topeka, KS 66606
Phone (785) 295-5310

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jshashank67193@direct.whhs.com
  • Direct secure messaging: sjolly1049969@direct.sentara.net
  • Direct secure messaging: sjolly1152403@direct.bsmhealth.org

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 5

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": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1902047814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 VICTORIA PL",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945061424",
            "telephone_number": "440-655-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE STE 305",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504439",
            "telephone_number": "209-755-8335",
            "fax_number": "209-575-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "SHASHANK",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-23",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A126261",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01081142A",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD430577",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ND",
            "license": "11204",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A126261",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902047814",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.