Individual provider Active NPI

Chirag M Shah, M.D., MPH

  • Retina Specialist (Ophthalmology) Physician
  • San Diego, CA
National Provider Identifier
1023472560
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
A155838 Issued in CA
Practice address
16766 Bernardo Center Dr
San Diego, CA 92128-2545
Phone
(858) 381-0686
Fax
(858) 365-5189
NPI assigned
Apr 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 036.153318 IL
Retina Specialist (Ophthalmology) Physician 207WX0107X A155838 CA Primary

Addresses

Primary practice location

16766 Bernardo Center Dr
San Diego, CA 92128-2545

Mailing address

16766 Bernardo Center Dr
San Diego, CA 92128-2545
Phone (858) 381-0686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 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
I20200602000139 IL Practitioner - Ophthalmology 1456609387 Reassigns benefits to 1 organization
I20221111000416 CA Practitioner - Ophthalmology 1456609387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16766 Bernardo Ctr Dr
Suite 206
San Diego, CA 92128-2502
Phone (858) 381-0686

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155838CAMDRetina Specialist (Ophthalmology) Physician
036.153318ILMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Results Medical Corporation CurrentSince Nov 1, 2022 Accepting new patients
Bonsai Health CurrentSince Mar 26, 2023 Accepting new patients
Eye Center Physicians, LTD. CurrentSince Jul 1, 2020 Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

8911 La Mesa Blvd
Ste 107A
La Mesa, CA 91942
Phone (858) 687-2020

16766 Bernardo Center Dr
San Diego, CA 92128
Phone (858) 229-3959

16766 Bernardo Center Dr
Ste 206
San Diego, CA 92128
Phone (858) 381-0686

1725 W Harrison St
Ste 906
Chicago, IL 60612
Phone (312) 733-7566

25 E Washington St
Ste 301
Chicago, IL 60602
Phone (312) 726-4949

71 W 156th St
Ste 400
Harvey, IL 60426
Phone (708) 596-8710

Interoperability endpoints

  • Direct secure messaging: cshah164345@direct.rush.rush-health.com

Organizations & group practices 4

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1023472560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16766 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282545",
            "telephone_number": "858-381-0686",
            "fax_number": "858-365-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16766 BERNARDO CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282545",
            "telephone_number": "858-381-0686",
            "fax_number": "858-365-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "CHIRAG",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036.153318",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A155838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.