SHANTHARAM PAI M.D. NPI 1053317537

NPI Information

NPI: 1053317537
Provider Name: SHANTHARAM PAI, M.D.
Classification: Family Medicine - 207QG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
2 W FERN AVE
REDLANDS, CA
ZIP 92373
Phone: (909) 799-7111
Get Directions

Shantharam Pai, M.D. is a geriatric medicine family medicine in Redlands, CA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. Shantharam Pai, M.D. NPI is 1053317537. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2 W FERN AVE
REDLANDS, CA
ZIP 92373-916
Phone: (909) 799-7111

The NPI 1053317537 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 8/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		A442860	CALIFORNIA	No
2	207QG0300X	Family Medicine	Geriatric Medicine	A442860	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E27394	MEDICARE UPIN	CALIFORNIA
2	A44286	MEDICARE PIN	CALIFORNIA
3	CA131554	OTHER	CALIFORNIA	MEDICARE
4	00A442860	OTHER	CALIFORNIA	BLUE SHIELD OF CA
5	00A442861	MEDICAID	CALIFORNIA
6	080101190	OTHER	GEORGIA	RAILROAD MEDICARE
7	00A442860	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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