Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1285121574 Individual Practitioner Female Practitioner

Dr. Shashanka Nethi , MBBS

Pediatrics • Bloomington, IN

Professional Overview & Biography Verified Profile Summary

Dr. Shashanka Nethi, MBBS is a registered healthcare professional specializing in Pediatrics in Bloomington, IN. Practice services are available at 811 W 2ND ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

811 W 2nd St

Bloomington, IN 474032212

Telephone 8123334001
Fax 8123334057

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Bloomington, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 26.7 Yrs
State Avg: 19.8 Yrs
Regional Practice Density
32 Specialists

Practicing in Bloomington, IN (1179 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-10-04
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IN 01085108A

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
300052974 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Evelyn Quigley , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1366165771

Psychiatric-Mental Health Nurse Practitioner

Rachel Behrend , NP

Nurse Practitioner - Family

NPI 1538623178

Nurse Practitioner

Sung Park , NP

Nurse Practitioner - Adult Health

NPI 1548442866

Nurse Practitioner

Elizabeth Mcknight , RN

Nurse Practitioner - Family

NPI 1578941852

Registered Nurse

Dr. Gregory Sutliff , MD

Internal Medicine

NPI 1831194604

Doctor of Medicine (M.D.)

Elizabeth Simon , LCAC

Counselor - Addiction (Substance Use Disorder)

NPI 1841832938

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 04, 2023

Pediatrics (License #01085108A in IN)

📍
Updated Practice Location August 16, 2021

Registered at 811 W 2ND ST, BLOOMINGTON, IN 474032212 (Tel: 8123334001)

📍
Updated Business Mailing Address August 16, 2021

Registered at 3403 E RAYMOND ST, INDIANAPOLIS, IN 462034744 (Tel: 3179572000)

📍
Updated Business Mailing Address January 07, 2019

Registered at 2201 HEMPSTEAD TURNPIKE PEDIATRICS - 18TH FLOOR, EAST MEADOW, NY 11554 (Tel: 5165726637)

NPI Profile Active April 23, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 23, 2018

Registered at 2201 HEMPSTEAD TURNPIKE, EAST MEADOW, NY 115541854 (Tel: 5165726637)

📍
Updated Business Mailing Address April 23, 2018

Registered at 2201 HEMPSTEAD TURNPIKE, EAST MEADOW, NY 115541854 (Tel: 5165726637)

👤
Provider Name / Credentials Updated April 23, 2018

Recorded as SHASHANKA NETHI, M.B.B.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 23, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285121574
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2018
Last Update: October 04, 2023
Sole Proprietor: No

Mailing Address

3403 E Raymond St

Indianapolis, IN 462034744

Phone: 3179572000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.