SHUBHA P SHETTY MD PA
NPI 1245682384
Family Medicine in Missouri City, TX
About Shubha P Shetty Md Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHUBHA P SHETTY MD PA (NPI 1245682384) is a healthcare organization registered as a family medicine in Missouri City, Texas and active in the NPI registry since July 2016. The organization holds a CLIA Waiver certificate valid through November 14, 2026 and lists Shubha Premnath Shetty, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shubha P Shetty Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Shubha P Shetty MD PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2121846
Shubha Shetty MD PA · Missouri City, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shubha P Shetty MD PA's NPI number?
The NPI number for Shubha P Shetty MD PA is 1245682384. It was assigned to this organization in the NPPES registry on July 12, 2016.
Where is Shubha P Shetty MD PA located?
Shubha P Shetty MD PA is located at 4502 Riverstone Blvd Suite 1003, Missouri City, TX 77459. The listed phone number is (972) 904-7683.
What is Shubha P Shetty MD PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Shubha P Shetty MD PA enrolled in Medicare?
Yes. Shubha P Shetty MD PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shubha P Shetty MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Shubha P Shetty MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shubha P Shetty MD PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2121846) is associated with this NPI, valid through November 14, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Shubha P Shetty MD PA was last updated on August 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shubha P Shetty Md Pa · NPI 1245682384
Family Medicine organization in Missouri City, Texas. Organization record, active in the CMS NPPES registry since July 12, 2016.
## Identity
- **NPI:** 1245682384 (Entity type: Organization)
- **Enumerated:** July 12, 2016
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Shubha Shetty, MD
## Practice location
- **Address:** 4502 RIVERSTONE BLVD, SUITE 1003, Missouri City, TX 77459-5204
- **Phone:** (972) 904-7683
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 8, 2016
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1245682384) · Data from the CMS NPPES public registry.