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Export Provider Record NPI 1023579349
Shivkumar Bhadola
Active
NPI Number1023579349
NPI TypeNPI-1 Individual
SpecialtyPsychiatry & Neurology, Neurology
Provider Details
NPI1023579349
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2019-03-28
Last Updated2024-10-14
Mailing AddressPo Box 415348
Boston, MA 02241-5348
United States
Phone: (002) 258-8858 | Fax: (508) 334-1977
📍 View Map
Primary Practice Address55 Lake Ave N
Worcester, MA 01655-0002
United States
Phone: (617) 414-5951 | Fax: (617) 414-9251
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes2084N0400X – Psychiatry & Neurology, NeurologyMA1019345
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About NPI 1023579349

Shivkumar Bhadola is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1023579349. The primary specialty listed is Psychiatry & Neurology, Neurology. The provider is located in Worcester, MA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2019-03-28. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1023579349?

NPI 1023579349 belongs to Shivkumar Bhadola, a Psychiatry & Neurology, Neurology in Worcester, MA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1023579349 active?

The current status of NPI 1023579349 in the NPPES registry is Active. The record was last updated on 2024-10-14.

What specialty is NPI 1023579349?

NPI 1023579349 is classified under the taxonomy Psychiatry & Neurology, Neurology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1023579349?

You can verify NPI 1023579349 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1023579349?

The primary practice address on file for NPI 1023579349 is 55 Lake Ave N, Worcester, MA 01655-0002. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1023579349 issued?

NPI 1023579349 was first issued (enumerated) on 2019-03-28. The NPPES record was last updated on 2024-10-14.

Practice Location Map

Shivkumar Bhadola is located at 55 Lake Ave N, Worcester, MA. Use the map below to find directions or verify the practice location.

📍 55 Lake Ave N, Worcester, MA 01655-0002  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Shivkumar Bhadola. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1023579349. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Psychiatry & Neurology, Neurology1019345MA
Data Verified from CMS NPPES Last synced: 2026-06-10 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162