Individual provider Active NPI

Rajal Dhruvish Shah, M.D.

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1043476476
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P9956 Issued in TX
Practice address
2200 Park Bend Dr
Suite 300
Austin, TX 78758-5387
Phone
(512) 836-5665
NPI assigned
Aug 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P9956 TX Primary
Internal Medicine Physician 207R00000X D0067922 MD

Addresses

Primary practice location

2200 Park Bend Dr
Suite 300
Austin, TX 78758-5387

Mailing address

2200 Park Bend Dr
Suite 300
Austin, TX 78758-5387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20150303002248 TX Practitioner - Internal Medicine 9133295033 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P9956TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Oct 1, 2016 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Union Hospital of Cecil County Internal Medicine Past Accepting new patients
Union Hospital of Cecil County Health Services, Inc Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

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.

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1043476476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "SUITE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-836-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAJAL",
        "middle_name": "DHRUVISH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P9956",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0067922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.