Individual provider Active NPI

Shawn Shaji, M.D.

  • Pediatric Cardiology Physician
  • Salt Lake City, UT
National Provider Identifier
1972096378
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
13896234-1205 Issued in UT
Practice address
81 Mario Capecchi Dr RM 4E207
Forbes Tower-Plaza Level Suite 140
Salt Lake City, UT 84112
Phone
(801) 581-2121
NPI assigned
Jun 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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 LL52598 SC
Pediatric Cardiology Physician 2080P0202X 13896234-1205 UT Primary

Addresses

Primary practice location

81 Mario Capecchi Dr RM 4E207
Forbes Tower-Plaza Level Suite 140
Salt Lake City, UT 84112

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Other practice location 1

4401 Penn Avenue
5th Floor Faculty Pavilion
Pittsburgh, PA 15224
Phone (412) 692-5540

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Bluemark LLC/ Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20181019002729 SC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7719230895

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13896234-1205UTMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services Pediatrics Past Accepting new patients

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1972096378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MARIO CAPECCHI DR RM 4E207",
            "address_2": "FORBES TOWER-PLAZA LEVEL SUITE 140",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Penn Avenue",
            "address_2": "5th Floor Faculty Pavilion",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "15224",
            "country_code": "US",
            "telephone_number": "412-692-5540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAJI",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL52598",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "UT",
            "license": "13896234-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.