Individual provider Active NPI

Sonal S Shah, MD

  • Pediatrics Physician
  • Gilbert, AZ
National Provider Identifier
1043367709
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34629 Issued in AZ
Practice address
4100 S Lindsay Rd
Ste 126
Gilbert, AZ 85297-1508
Phone
(480) 892-3500
Fax
(480) 892-0695
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34629 AZ Primary

Addresses

Primary practice location

4100 S Lindsay Rd
Ste 126
Gilbert, AZ 85297-1508

Mailing address

4100 S Lindsay Rd
Ste 126
Gilbert, AZ 85297-1506
Phone (480) 892-3500

Other identifiers 4

IdentifierTypeStateIssuer
1829948OtherAZCIGNA
7704200OtherAZAETNA US HEALTHCARE
079121MedicaidAZ
3Z1175OtherAZHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34629AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leitchfield Pediatric Clinic P.S.C. Pediatrics Past Accepting new patients
Sunrise Pediatrics, PLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61385

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1043367709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 S LINDSAY RD",
            "address_2": "STE 126",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971506",
            "telephone_number": "480-892-3500",
            "fax_number": "480-892-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S LINDSAY RD",
            "address_2": "STE 126",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971508",
            "telephone_number": "480-892-3500",
            "fax_number": "480-892-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SONAL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "34629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1829948",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7704200",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079121",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z1175",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.