Individual provider Active NPI

Kairav Rameshchandra Shah, MD

  • Psychiatry Physician
  • Modesto, CA
National Provider Identifier
1053660886
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A142095 Issued in CA
Practice address
1524 McHenry Ave Ste 445
Modesto, CA 95350-4573
Phone
(209) 571-1693
NPI assigned
Sep 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 268942 NY
Pain Medicine Physician 208VP0000X ME134702 FL
Psychiatry Physician 2084P0800X A142095 CA Primary

Addresses

Primary practice location

1524 McHenry Ave Ste 445
Modesto, CA 95350-4573

Mailing address

1524 McHenry Ave Ste 445
Modesto, CA 95350-4573
Phone (209) 571-1693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, 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
I20190130001068 FL Practitioner - Interventional Pain ManagementPractitioner - Psychiatry 7911123740 Reassigns benefits to 5 organizations
I20200706001363 CA Practitioner - Interventional Pain ManagementPractitioner - Psychiatry 7911123740 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Pain Management Medical Group IncGroup PAC ID 0547252918, 42 clinicians

Practice addresses (Care Compare)

1524 McHenry Ave
Suite 445
Modesto, CA 95350-4573
Phone (209) 571-1693

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
National Surgical Centers of America LLC CurrentSince Nov 1, 2019 Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince Sep 15, 2018 Accepting new patients
Integrated Pain Management Medical Group, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Traditions Psychiatry Group, P.C Psychiatry CurrentSince Sep 1, 2020 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 3, 2023 Accepting new patients
National Surgical Centers of America LLC CurrentSince Nov 1, 2019 Accepting new patients
Florida Pain and Rehabilitation Associates Inc Current Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince Sep 15, 2018 Accepting new patients
Permanente Medical Group Inc Psychiatry CurrentSince Jul 3, 2023 Accepting new patients
National Surgical Centers of America LLC CurrentSince Nov 1, 2019 Accepting new patients
NJ Behavioral Care Inc. Psychiatry PastSince Nov 1, 2021 Accepting new patients

Locations (25 of 28)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

7111 N Fresno St
Ste 100
Fresno, CA 93720
Phone (559) 878-5080

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1524 McHenry Ave
Ste 445
Modesto, CA 95350
Phone (209) 571-0288

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

3825 Hopyard Rd
Ste 140
Pleasanton, CA 94588
Phone (925) 847-5051

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

650 University Ave
Ste 100
Sacramento, CA 95825
Phone (916) 333-5800

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2410 Merced St
San Leandro, CA 94577
Phone (510) 278-2700

999 N Tustin Ave
Ste 201
Santa Ana, CA 92705
Phone (714) 975-7950

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

450 N Wiget Ln
Walnut Creek, CA 94598
Phone (925) 413-4960

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

5365 Atlantic Ave
Ste 504
Delray Beach, FL 33484
Phone (561) 241-9300

5365 Atlantic Ave
Ste 501
Delray Beach, FL 33484
Phone (561) 279-3500

150 SW Chamber Ct
Ste 105
Port St Lucie, FL 34986
Phone (772) 807-9000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 12

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 12

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": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1053660886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE STE 445",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504573",
            "telephone_number": "209-571-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE STE 445",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504573",
            "telephone_number": "209-571-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAIRAV",
        "middle_name": "RAMESHCHANDRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-07",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "268942",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME134702",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A142095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.