Kavita Sanjiv Shah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K9415 Issued in TX

Practice address

909 Southeast Pkwy Ste 105
Azle, TX 76020-3600

Phone

(817) 238-0735

Fax

(817) 238-7327

NPI assigned

Jan 25, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Strategic Medical Group TX PLLCGroup PAC ID 1355707423, 26 clinicians

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Azle Hospital, Azle, TX, CCN 450419
• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshah25158@direct.texashealth.org
• FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

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

• Strategic Medical Group TX PLLC

  • Primary Care Clinic/Center
  • Fort Worth, TX
  • NPI 1053027680
  Medicare reassignment Care Compare group NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Texas Health Harris Methodist Hospital Azle

  • General Acute Care Hospital
  • Azle, TX
  • NPI 1508899204
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Texas Health Harris Methodist Hospital Azle

  • General Acute Care Hospital
  • Azle, TX
  • NPI 1508899204
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1023088507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SOUTHEAST PKWY STE 105",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203600",
            "telephone_number": "817-238-0735",
            "fax_number": "817-238-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SOUTHEAST PKWY STE 105",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203600",
            "telephone_number": "817-238-0735",
            "fax_number": "817-238-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAVITA",
        "middle_name": "SANJIV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K9415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040230702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040230701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chakirra Seastrunk
• Segue Health of Texas PLLC
• Sarah Amily Sepulveda Farrar, FNP-C
• Melissa Sepulveda, CPC-A
• Andrew Sewell, DPT
• Tiffany Shaw, LAT, C.PH.T
• Shiny Studio PLLC
• Silver Creek Al LLC
• Silver Creek Place LTD.
• Richard J Smiley, PTA

• Internal Medicine Physician in Azle, TX
• Providers in Azle, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.