Sampurna Shakya, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35.139245 Issued in OH

Practice address

2422 Lake Ave
Ashtabula, OH 44004-4985

Phone

(440) 997-6980

Fax

(440) 994-7514

NPI assigned

Apr 6, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ashtabula County Medical Center

  dba The Ashtabula Clinic

  • Specialist
  • Ashtabula, OH
  • NPI 1942247143

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1992238984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-997-6980",
            "fax_number": "440-994-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-997-6980",
            "fax_number": "440-994-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKYA",
        "first_name": "SAMPURNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.139245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Ann Sesler
• Christi Seth, LISW
• Melissa J. Severino-Hoza, D.D.S.
• Crystal Lynn Severino, NP-C
• Gregory Carl Seymour, D.D.S.
• Jason Corbett Shaw
• Dennis Anthony Shepard, LPTA
• Brandi Sherman
• Kathleen Shontz, NP-C
• Jessica Shumaker

• Pediatrics Physician in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.