Jay Shah, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

20A16182 Issued in CA

Practice address

2140 Grand Ave Ste 125
Chino Hills, CA 91709-6802

Phone

(909) 630-7875

Fax

(909) 469-2107

NPI assigned

May 5, 2016

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Family PracticeAlso: Sports Medicine

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Premier Family Medicine Associates, IncGroup PAC ID 4284547522, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Premier Family Medicine Associates, Inc

  • Health Service Clinic/Center
  • Pomona, CA
  • NPI 1912907114
  Medicare reassignment Care Compare group NPD
• California Cardiovascular Consultants

  • Internal Medicine Physician
  • Fremont, CA
  • NPI 1932202959
  Medicare reassignment NPD
• California Cardiovascular Consultants Medical Associates

  • Internal Medicine Physician
  • Newark, CA
  • NPI 1538358122
  NPD
• Premier Family Medicine Associates, Inc

  • Health Service Clinic/Center
  • La Verne, CA
  • NPI 1033634373
  NPD
• Premier Family Medicine Associates, Inc

  • Health Service Clinic/Center
  • Claremont, CA
  • NPI 1164668786
  NPD
• Premier Family Medicine Associates, Inc

  • Health Service Clinic/Center
  • Chino Hills, CA
  • NPI 1730112426
  NPD (past)

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

• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1407813660
  Care Compare affiliation

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1023464336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 GRAND AVE STE 125",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096802",
            "telephone_number": "909-630-7875",
            "fax_number": "909-469-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 GRAND AVE STE 125",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096802",
            "telephone_number": "909-630-7875",
            "fax_number": "909-469-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A16182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023464336",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Sento, BS, PTA, CSCS
• Erika M Sequeira, DDS
• Amanda Sevilla, RD
• Patricia Bandera Sevilla
• Akash Ketan Shah, M.D.
• Simran Shah
• Uday N Shah, D.D.S.
• Parvin Shaker
• Darrell Shen, DMD
• Eric Franklin Shih, PHARMD

• Sports Medicine (Family Medicine) Physician in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.