NPIMap

Individual provider Active NPI

Jagruti Nimit Shah, MD

  • Internal Medicine Physician
  • Toledo, OH
National Provider Identifier
1083060263
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35135666 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606
Phone
(419) 291-4000
Fax
(419) 479-6102
NPI assigned
May 6, 2016
Reactivated
Jan 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 35135666 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606

Mailing address

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

Other practice location 1

2213 Franklin Ave
Mercy Family Care Center
Toledo, OH 43620
Phone (419) 251-2360

Other practice location 2

2213 Franklin Ave
Mercy Family Care Center
Toledo, OH 43620
Phone (419) 251-2360

Other names 1

  • Jagruti Narendrakumar Shah Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jshah168786@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190604002083 OH Practitioner - Internal Medicine 9638402704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

1601 Brigham Dr
Suite 200
Perrysburg, OH 43551-7117
Phone (567) 585-0380

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Fostoria Community Hospital Hospital, Fostoria, OH, CCN 361318
  • Flower Rehabilitation Center Inpatient rehabilitation facility, Sylvania, OH, CCN 36T068

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Jun 1, 2019 Accepting new patients
Promedica Central Physicians Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Fostoria Hospital Association Past Accepting new patients
Memorial Hospital Past Accepting new patients
Bay Park Community Hospital Past Accepting new patients
The Toledo Hospital Past Accepting new patients

Locations

1601 Brigham Dr
Ste 200
Perrysburg, OH 43551
Phone (419) 872-7700

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

1091 Pray Blvd
Waterville, OH 43566
Phone (419) 785-3282

Interoperability endpoints

  • Direct secure messaging: jshah168786@direct.promedica.org

Organizations & group practices 7

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 7

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1083060263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-4000",
            "fax_number": "419-479-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43606",
            "telephone_number": "419-291-4000",
            "fax_number": "419-479-6102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Franklin Ave",
            "address_2": "Mercy Family Care Center",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43620",
            "country_code": "US",
            "telephone_number": "419-251-2360",
            "fax_number": "419-251-2343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Franklin Ave",
            "address_2": "Mercy Family Care Center",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43620",
            "country_code": "US",
            "telephone_number": "419-251-2360",
            "fax_number": "419-251-2343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAGRUTI",
        "middle_name": "NIMIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2023-11-03",
        "deactivation_date": "2017-01-05",
        "reactivation_date": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35135666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshah168786@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAGRUTI",
            "last_name": "SHAH",
            "middle_name": "NARENDRAKUMAR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.