Nandkishor Shah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0057806 Issued in FL

Practice address

6450 38TH Ave N
Suite# 100
St Petersburg, FL 33710-1645

Phone

(727) 347-2780

Fax

(727) 347-5508

NPI assigned

Apr 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nick Shah Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gulfcoast Medical &Geriatric Care Inc

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1649392119
  Authorized official Same address or phone
• Gulfcoast Medical Associates

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1114100187
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003939224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 38TH AVE N",
            "address_2": "SUITE# 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101645",
            "telephone_number": "727-347-2780",
            "fax_number": "727-347-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 38TH AVE N",
            "address_2": "SUITE# 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101645",
            "telephone_number": "727-347-2780",
            "fax_number": "727-347-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NANDKISHOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0057806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259995300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICK",
            "last_name": "SHAH",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kevin Shah
• Kunal Shah, MD
• Manan Shah, PHARMD
• Mehul B Shah, MD
• Mona Shah, MD
• Nilamben D Shah, MD
• Priya Rupesh Shah, DMD
• Reema Shah, PHARMD
• Rohan Shah, MD
• Samir C Shah, MD

• Internal Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.