Pankajkumar C Shah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

40815 Issued in KY

Practice address

320 W 18TH St
Hopkinsville, KY 42240-1965

Phone

(270) 887-0100

Fax

(270) 887-0342

NPI assigned

May 31, 2007

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 2

Medicare fee-for-service enrollment

Enrolled in KY, TN2 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

Specialty

Internal Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pennyroyal Healthcare Services, IncGroup PAC ID 6002076700, shared by 3 NPIs, 11 clinicians

Elite Medical Group of Clarksville PLLCGroup PAC ID 7618461161, 2 clinicians

Jennie Stuart Medical Center IncGroup PAC ID 4183607252, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jennie Stuart Medical Center Hospital, Hopkinsville, KY, CCN 180051
• Trigg County Hospital Hospital, Cadiz, KY, CCN 181304
• Vanderbilt Clarksville Hospital Hospital, Clarksville, TN, CCN 440035
• Baptist Health Deaconess Madisonville Hospital, Madisonville, KY, CCN 180093
• Caldwell Medical Center Hospital, Princeton, KY, CCN 181322
• Christian Health Center Nursing home, Hopkinsville, KY, CCN 185147

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jennie Stuart Medical Center Inc

  • General Acute Care Hospital
  • Hopkinsville, KY
  • NPI 1235139312
  Medicare reassignment Care Compare group NPD
• Elite Medical Group of Clarksville PLLC

  • Family Medicine Physician
  • Clarksville, TN
  • NPI 1861364887

  Internal Medicine, KY

  Medicare reassignment Care Compare group NPD
• Pennyroyal Healthcare Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hopkinsville, KY
  • NPI 1124319942
  Medicare reassignment NPD
• Jennie Stuart Medical Center Inc

  • Family Nurse Practitioner
  • Hopkinsville, KY
  • NPI 1790086767
  NPD
• Jennie Stuart Medical Center Inc

  • Rural Health Clinic/Center
  • Hopkinsville, KY
  • NPI 1912627605
  NPD
• Pennyroyal Healthcare Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Hopkinsville, KY
  • NPI 1104532332
  NPD
• Pennyroyal Healthcare Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Princeton, KY
  • NPI 1740672617
  NPD

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

• Baptist Health Deaconess Madisonville Inc

  • Rural Acute Care Hospital
  • Madisonville, KY
  • NPI 1447231956
  Care Compare affiliation
• Caldwell County Hospital, Inc

  • Occupational Medicine Physician
  • Princeton, KY
  • NPI 1780688333

  Hospital

  Care Compare affiliation
• Christian Care Communities, Inc.

  • Skilled Nursing Facility
  • Hopkinsville, KY
  • NPI 1689711806

  Nursing home

  Care Compare affiliation
• Jennie Stuart Medical Center Inc

  • General Acute Care Hospital
  • Hopkinsville, KY
  • NPI 1235139312
  Care Compare affiliation
• Trigg County Hospital, Inc

  • Critical Access Hospital
  • Cadiz, KY
  • NPI 1538218680
  Care Compare affiliation
• Clarksville Health System, LLC

  • General Acute Care Hospital
  • Clarksville, TN
  • NPI 1285689794
  Care Compare affiliation

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1043412356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422410055",
            "telephone_number": "270-887-0100",
            "fax_number": "270-887-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 18TH ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401965",
            "telephone_number": "270-887-0100",
            "fax_number": "270-887-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PANKAJKUMAR",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "40815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000526170",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100016400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Carolyn Self, LCSW
• Patrick Shafer, O.D.
• Paula Shaffer
• Dhara P Shah, PT
• Ketki P Shah, PT
• Parth H Shah, MD
• Prakash Shah, MD
• Dustin Shaw, PHARMD
• Monica Moss Shelton, KY CERT. 1ST ASSIST
• Hannah Shemwell

• Internal Medicine Physician in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; 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.