Individual provider Active NPI

Mihir S Shah, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Milwaukee, WI
National Provider Identifier
1023366010
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
036134178 Issued in IL
Practice address
2901 W Kinnickinnic River Pkwy Ste 315
Milwaukee, WI 53215-3660
Phone
(414) 649-5646
NPI assigned
Aug 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 63727 WI
Neurology Physician 2084N0400X 036134178 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036134178 IL Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy Ste 315
Milwaukee, WI 53215-3660

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 649-6000

Other practice location 1

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (847) 802-7400

Other identifiers 1

IdentifierTypeStateIssuer
100045987MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mshah155862@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171031001281 WI Practitioner - Critical Care (Intensivists) 8325314727 Reassigns benefits to 1 organization
I20230823001477 IL Practitioner - Critical Care (Intensivists)Practitioner - Neurology 8325314727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4874

Hospital & facility affiliations

  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63727WIMDCritical Care Medicine (Internal Medicine) Physician
036134178ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Central Dupage Physician Group CurrentSince Jul 9, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 26, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 20, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 20, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 26, 2017 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 9, 2023 Accepting new patients
Aurora Medical Group, Inc. PastSince Nov 28, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

360 Station Dr
Ste 300
Crystal Lake, IL 60014
Phone (815) 455-1800

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 385-3084

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2901 W Kinnickinnic River Pkwy
Ste 315
Milwaukee, WI 53215
Phone (414) 385-2590

Interoperability endpoints

  • Direct secure messaging: mshah155862@direct.myadvocateaurora.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1023366010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "414-649-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 315",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-649-5646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "847-802-7400",
            "fax_number": "847-802-7399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MIHIR",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-22",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WI",
            "license": "63727",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036134178",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036134178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100045987",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshah155862@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 W Kinnickinnic River Pkwy Ste 315",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2901 W Kinnickinnic River Pkwy Ste 315",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.