SANDYA SHIVASHANKAR (M.D.) – Family Medicine Physician, NPI 1184039422

SANDYA SHIVASHANKAR (M.D.) is a healthcare provider. based in Coppell, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. R3959 (TX). The NPI Number for SANDYA SHIVASHANKAR (M.D.) is 1184039422

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
SANDYA SHIVASHANKAR (M.D.)
NPI
1184039422
Phone
(972) 906-8107
Address
645 E STATE HIGHWAY 121 STE 600
Enumeration Date
25 June 2014
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4692322945
Graduation Year
2013 (13 years ago)
PAC ID
4486870961
Group Practice PAC ID
7810237740
Professional Enrollment ID
I20210915002319
Address ID
TX750803695RI377XXRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for SANDYA SHIVASHANKAR (M.D.)

  • 645 E STATE HIGHWAY 121 STE 600

    COPPELL, TX 750197942

    Phone: (972) 906-8107

    Fax: (972) 956-8887

    Type: Mailing

  • 12801 MIDWAY RD STE 503

    DALLAS, TX 752446303

    Phone: (972) 243-3304

    Fax: (972) 243-3717

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-09-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210915002319IFamily PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75019)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810237740View full group profile
NameSpecialtyState
-TX
Nurse PractitionerTX
Family PracticeLA
Physician AssistantTX
Family PracticeTX
Nurse PractitionerTX
Family PracticeKY
Physician AssistantMA
-TX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I verify SANDYA SHIVASHANKAR (M.D.) with an NPI only?
You can start verification with NPI 1184039422 for SANDYA SHIVASHANKAR (M.D.), then check state licensing separately.
Does CMS list SANDYA SHIVASHANKAR (M.D.) as active?
Yes — SANDYA SHIVASHANKAR (M.D.) is active in the NPI listing used on this page.
What taxonomy line describes SANDYA SHIVASHANKAR (M.D.)?
For research purposes, treat SANDYA SHIVASHANKAR (M.D.) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for SANDYA SHIVASHANKAR (M.D.)?
SANDYA SHIVASHANKAR (M.D.)'s geographic hint is Coppell, Texas in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.