Individual provider Active NPI

Shyam Parshottam Kasundra, M.D.

  • Family Medicine Physician
  • Rochester, MN
National Provider Identifier
1942615562
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
69939 Issued in WI
Practice address
200 1St Street SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Jun 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2017-02208 NC
Hospitalist Physician 208M00000X 24772 MS
Family Medicine Physician 207Q00000X 69939 WI Primary

Addresses

Primary practice location

200 1St Street SW
Rochester, MN 55905-0001

Mailing address

200 1St Street SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

303 Medical Center Dr
Batesville, MS 38606-8608
Phone (662) 563-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, OH, NC, WI4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20170802001500 MS Practitioner - Family PracticePractitioner - Emergency Medicine 1951697143
I20180301002717 OH Practitioner - HospitalistPractitioner - Internal Medicine 1951697143 Reassigns benefits to 1 organization
I20180426001755 NC Practitioner - HospitalistPractitioner - Family Practice 1951697143 Reassigns benefits to 4 organizations
I20181010003006 WI Practitioner - HospitalistPractitioner - Internal Medicine 1951697143 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-02208NCMDFamily Medicine Physician
69939WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of North Carolina - Rocky Mount CurrentSince Jun 9, 2019 Accepting new patients
Apogee Medical Group North Carolina Hospitalist CurrentSince Feb 6, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Cogent Healthcare of North Carolina, PC Family Medicine CurrentSince Jun 9, 2019 Accepting new patients
Apogee Medical Group Ohio Inc CurrentSince Jan 31, 2018 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist CurrentSince Apr 1, 2021 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Hospitalist Medicine Physicians of North Carolina PLLC CurrentSince Jun 1, 2019 Accepting new patients
Ipn of Arizona, PLC Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Cloud Health Medical Group of California, P.C. Family Medicine Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1303 S Main St
Holmen, WI 54636
Phone (608) 526-1526

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

Organizations & group practices 11

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1942615562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "MS",
            "postal_code": "386068608",
            "country_code": "US",
            "telephone_number": "662-563-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASUNDRA",
        "first_name": "SHYAM",
        "middle_name": "PARSHOTTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-02208",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "24772",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "69939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.