SHANTA GAUTHAM MD
NPI 1851562375
Internal Medicine in Grand Forks, ND

Q: What is Shanta Gautham's NPI number?

The NPI number for Shanta Gautham is 1851562375. It was assigned to this individual provider in the NPPES registry on March 13, 2008.

Q: What is Shanta Gautham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Shanta Gautham was last updated on March 5, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 13, 2008PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY, GRAND FORKS, ND 58203(701) 780-6800(781) 744-5358 Get Directions Write a Review

NPPES record last updated: March 5, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 5, 2019, Mar 1, 2019 (2 updates tracked since 2019).

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About Shanta Gautham Md NPPES

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

SHANTA GAUTHAM MD (NPI 1851562375) is an individual internal medicine provider in Grand Forks, North Dakota, licensed in North Dakota (11672) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS, is affiliated with Altru Hospital, and is a graduate of University Of Missouri, Columbia School Of Medicine (2007).

NPPES Registry Identity

NPI1851562375

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameSHANTA GAUTHAMCredential: MD

Location Address725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCYGrand Forks, ND 58203

Mailing Address2401 Demers AveGrand Forks, ND 58201 · (701) 780-1891 · Fax (781) 744-5358

Phone(701) 780-6800

Fax(781) 744-5358

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 2007

Enumeration DateMarch 13, 2008

Last NPPES UpdateMarch 5, 20192 updates tracked since enumeration

✔ NPI 1851562375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in ND · 11672

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY, Grand Forks, ND 58203

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Other Names 1

Former Name (1)Shanta Subramanian Md

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan.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

Shanta Gautham 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 ID9133309685

PECOS Enrollment IDI20110215001140, I20200826000351

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 10

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.

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.

504 services277 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.

468 services307 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

198 services198 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

52 services47 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

31 services31 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

23 services23 patients

Hospital Affiliations CMS Care Compare

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

Altru Hospital

Acute Care Hospitals · Grand Forks, ND

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number350019

Location1200 S Columbia RdGrand Forks, ND 58201 · Grand Forks County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58203 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

$127.45 typical visit price

range $55.75 – $168.12

Typical copayment $31.86 (range $13.93 – $42.03)

Most-billed visit code 99204

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers95 claims156 services$5.93 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers20 claims21 services$1.02 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

1 supplier11 claims14 services$35.68 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

2 suppliers15 claims69 services$21.09 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

2 suppliers23 claims23 services$53.23 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

2 suppliers19 claims19 services$17.15 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

ANDREW V GASPARINI MD

Family Medicine