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RAINA SHIVASHANKAR MD
NPI 1699096347
Internal Medicine - Gastroenterology in Philadelphia, PA

Active since June 17, 2010PECOS EnrolledAccepts Medicare Assignment
1101 CHESTNUT ST, PHILADELPHIA, PA 19107(215) 955-8900(215) 923-3447 Get Directions Write a Review

NPPES record last updated: October 28, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Raina Shivashankar Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAINA SHIVASHANKAR MD (NPI 1699096347) is an individual gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD456659) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS, is affiliated with Thomas Jefferson University Hospital, and is a graduate of Hahnemann University College Of Medicine (2010).

NPPES Registry Identity

NPI1699096347
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameRAINA SHIVASHANKARCredential: MD
Location Address1101 CHESTNUT STPhiladelphia, PA 19107-3612
Mailing Address132 S 10th St, 480 Main BuildingPhiladelphia, PA 19107-5244 · (215) 955-8900 · Fax (215) 923-3447
Phone(215) 955-8900
Fax(215) 923-3447
Sole ProprietorNo
Medical School CMSHahnemann University College Of MedicineGraduated 2010
Enumeration DateJune 17, 2010
Last NPPES UpdateOctober 28, 2024
NPPES CertifiedOctober 28, 2024
✔ NPI 1699096347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in PA · MD456659✔ Licensed in MN · 54258
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 54258 (MN)
1101 CHESTNUT ST, Philadelphia, PA 19107
Open in Google Maps ↗

Other Identifiers 1

OtherP01105546MN · Medicare Railroad

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Raina Shivashankar Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305018953
PECOS Enrollment IDI20160531002410
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
34 services19 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
29 services22 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
27 services25 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
25 services25 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
17 services13 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390174
Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY RUBIN R.D.
Dietitian, Registered
1101 CHESTNUT ST
PHILA, PA 19107
Philadelphia County (215) 955-8900
LAUREL VIRGINIA KOVALCHICK MD
Psychiatry & Neurology (Neurology)
1101 CHESTNUT ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-1234
CHRISTOPHER JAMES ADKINS M.D.
Internal Medicine (Gastroenterology)
1101 CHESTNUT ST
PHILA, PA 19107
Philadelphia County (215) 955-8900
SARAH F ADAMS CCC-SLP
Speech-Language Pathologist
1101 CHESTNUT ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6760
REBECCA LOH
Internal Medicine (Gastroenterology)
1101 CHESTNUT ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-8900
EDDIE DIAZ SERRANO AUD
Audiologist
1101 CHESTNUT ST
PHILADELPHIA, PA 19107
Philadelphia County (215) 955-6760
RORY MARGARET ANDERSON CRNP
Nurse Practitioner (Family)
1101 CHESTNUT ST
PHILADELPHIA, PA 19107
Philadelphia County (800) 533-3669
MAEVE CALLAHAN CRNP
Nurse Practitioner (Adult Health)
1101 CHESTNUT ST
PHILADELPHIA, PA 19107
Philadelphia County (800) 533-3669

Frequently 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 Raina Shivashankar's NPI number?

The NPI number for Raina Shivashankar is 1699096347. It was assigned to this individual provider in the NPPES registry on June 17, 2010.

Where is Raina Shivashankar located?

Raina Shivashankar practices at 1101 Chestnut St, Philadelphia, PA 19107. The listed phone number is (215) 955-8900.

What is Raina Shivashankar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Raina Shivashankar enrolled in Medicare?

Yes. Raina Shivashankar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Raina Shivashankar accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Raina Shivashankar as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Raina Shivashankar affiliated with any hospitals?

According to CMS data, Raina Shivashankar is affiliated with Thomas Jefferson University Hospital.

When was this NPI record last updated?

The NPPES record for Raina Shivashankar was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.