Individual provider Active NPI

Rajan V. Shah, MD

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1063707073
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.136013 Issued in IL
Practice address
199 Scott St FL 8
Buffalo, NY 14204-2208
Phone
(917) 261-4414
NPI assigned
Jun 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X U6897 TX
Internal Medicine Physician 207R00000X 036.136013 IL Primary
Internal Medicine Physician 207R00000X 318467 NY
Internal Medicine Physician 207R00000X D98635 MD
Internal Medicine Physician 207R00000X C188638 CA

Addresses

Primary practice location

199 Scott St FL 8
Buffalo, NY 14204-2208

Mailing address

199 Scott St FL 8
Buffalo, NY 14204-2208
Phone (917) 261-4414

Other practice location 1

1110 N Virgil Ave
Los Angeles, CA 90029-2016
Phone (917) 261-4414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20150121000823 GU Practitioner - Internal Medicine 6608190731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Chicago College of Medicine and Surgery, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guam Memorial HospitalGroup PAC ID 5890781694, 132 clinicians

Practice addresses (Care Compare)

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3128
Phone (671) 647-2552

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C188638CAMDInternal Medicine Physician
036.136013ILMDInternal Medicine Physician
D98635MDMDInternal Medicine Physician
318467NYMDInternal Medicine Physician
U6897TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince Nov 10, 2014 Accepting new patients
Guam Memorial Hospital CurrentSince Nov 10, 2014 Accepting new patients
Eden Health Medical of Il LTD Internal Medicine PastSince Nov 24, 2024 Accepting new patients
Eden Health Medical PC Internal Medicine PastSince Nov 24, 2024 Accepting new patients

Locations

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

Interoperability endpoints

  • Direct secure messaging: rajan.shah.2@15349.direct.athenahealth.com

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1063707073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 SCOTT ST FL 8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142042208",
            "telephone_number": "917-261-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 SCOTT ST FL 8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142042208",
            "telephone_number": "917-261-4414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 N Virgil Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900292016",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAJAN",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U6897",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.136013",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "318467",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D98635",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C188638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.