Individual provider Active NPI

Akshatha Shetty, M.D.

  • Psychiatry Physician
  • Naperville, IL
National Provider Identifier
1932289329
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036139474 Issued in IL
Practice address
1560 Wall St
Suite # 304
Naperville, IL 60563-1123
Phone
(630) 416-8289
Fax
(630) 416-8306
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036139474 IL Primary
Psychiatry Physician 2084P0800X 35088503 OH

Addresses

Primary practice location

1560 Wall St
Suite # 304
Naperville, IL 60563-1123

Mailing address

1560 Wall St Ste 304
Naperville, IL 60563-1262
Phone (630) 416-8289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20160316000999 IL Practitioner - Psychiatry 3476551094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conventions Psychiatry and Counseling PCGroup PAC ID 0143113027, 17 clinicians

Practice addresses (Care Compare)

8540 S Harlem Ave
Bridgeview, IL 60455-1778
Phone (708) 598-2605

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036139474ILMDPsychiatry Physician
35088503OHMDPsychiatry Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1932289329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 WALL ST STE 304",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631262",
            "telephone_number": "630-416-8289",
            "fax_number": "630-416-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 WALL ST",
            "address_2": "SUITE # 304",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631123",
            "telephone_number": "630-416-8289",
            "fax_number": "630-416-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "AKSHATHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036139474",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35088503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.