NPIMap

Individual provider Active NPI

Ronak Chandrakant Shah, M.D.

  • Nephrology Physician
  • Modesto, CA
National Provider Identifier
1033145800
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A93749 Issued in CA
Practice address
600 Coffee Rd
Modesto, CA 95355-4201
Phone
(209) 521-6097
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A93749 CA Primary

Addresses

Primary practice location

600 Coffee Rd
Modesto, CA 95355-4201

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

Other identifiers 1

IdentifierTypeStateIssuer
00A937490MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061003000687 CA Practitioner - NephrologyPractitioner - Internal Medicine 7012816697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

2800 L St
Sacramento, CA 95816-5616

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

815 Court St
Jackson, CA 95642-2154

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93749CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System PastSince Feb 25, 2012 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
United Hospital District Inc. PastSince Oct 31, 2021 Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Oroville Hospital Past Accepting new patients
Wellbound of Modesto LLC PastSince Jul 1, 2008 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
United Hospital District Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rshah53962@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1033145800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RONAK",
        "middle_name": "CHANDRAKANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A93749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A937490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.