Individual provider Active NPI

Pooja Shah, M.D.

  • Psychiatry Physician
  • Olympia Fields, IL
National Provider Identifier
1083077903
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036172040 Issued in IL
Practice address
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone
(219) 866-5141
Fax
(708) 679-2161
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4878 WI
Psychiatry Physician 2084P0800X MD468674 PA
Psychiatry Physician 2084P0800X 25MA11569300 NJ
Child & Adolescent Psychiatry Physician 2084P0804X MT217563 PA
Psychiatry Physician 2084P0800X 036172040 IL Primary

Addresses

Primary practice location

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Mailing address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-7131

Other practice location 1

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (888) 227-3898

Other practice location 2

515 22nd Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

Other practice location 3

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pshah525476@direct-ehr-ssmhc.com Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, VT, PA, WI, IL, MO7 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 7

Enrollment IDStateProvider typePAC IDDetails
I20230419000062 NY Practitioner - Psychiatry 8325386857 Reassigns benefits to 1 organization
I20230928000224 NJ Practitioner - Psychiatry 8325386857 Reassigns benefits to 3 organizations
I20240904002956 VT Practitioner - Psychiatry 8325386857 Reassigns benefits to 1 organization
I20240930004072 PA Practitioner - Psychiatry 8325386857 Reassigns benefits to 3 organizations
I20241119001467 WI Practitioner - Psychiatry 8325386857 Reassigns benefits to 2 organizations
I20250102001068 IL Practitioner - Psychiatry 8325386857 Reassigns benefits to 4 organizations
I20250116002071 MO Practitioner - Psychiatry 8325386857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians
The Monroe Clinic, Inc.Group PAC ID 3072425495, 199 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (557) 203-1601

12303 Depaul Dr
SSM Health Depaul Hospital Physician Billin
Bridgeton, MO 63044-2512
Phone (314) 344-6000

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

Hospital & facility affiliations

  • SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091
  • SSM St Clare Health Center Hospital, Fenton, MO, CCN 260081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11569300NJMDPsychiatry Physician
MD468674PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pooja Shah MD Psychiatry Current Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Nov 1, 2024 Accepting new patients
Main Line Healthcare CurrentSince Oct 1, 2024 Accepting new patients
Gifford Medical Center Inc. CurrentSince Aug 26, 2024 Accepting new patients
Albany Medical College CurrentSince Jan 11, 2023 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jan 1, 2025 Accepting new patients
Albany Medical College CurrentSince Jan 11, 2023 Accepting new patients
Agnesian Healthcare Inc CurrentSince Nov 11, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Nov 11, 2024 Accepting new patients
Specialty Physicians of Illinois, LLC Current Accepting new patients
The Monroe Clinic, Inc. CurrentSince Dec 10, 2024 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Dec 10, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jun 16, 2023 Accepting new patients
SSM Health Care St. Louis CurrentSince Nov 26, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Dec 1, 2024 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Jun 23, 2024 Accepting new patients
Fornance Physician Services Inc CurrentSince Jun 23, 2024 Accepting new patients
Atlanticare Behavioral Health, Inc CurrentSince Jun 16, 2023 Accepting new patients
Atlanticare Behavioral Health, Inc. Current Accepting new patients
Ellis Hospital CurrentSince Dec 30, 2025 Accepting new patients
Trinity Health Mid-Atlantic Medical Group Current Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jan 1, 2025 Accepting new patients
Gifford Medical Center Inc CurrentSince Aug 26, 2024 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Nov 1, 2024 Accepting new patients
Albany Medical College Psychiatry CurrentSince Jan 11, 2023 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois Current Accepting new patients
SSM Health Care St Louis CurrentSince Nov 26, 2024 Accepting new patients
Atlanticare Physician Group PA CurrentSince Jun 16, 2023 Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Jan 15, 2025 Accepting new patients
Fornance Physician Services, Inc Current Accepting new patients

Locations (25 of 33)

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

35318 Eagle Way
Chicago, IL 60678

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

13000 Butler Crest Dr
Saint Louis, MO 63128
Phone (314) 842-3535

12800 Corporate Hill Dr
Saint Louis, MO 63131
Phone (314) 989-6430

6010 Black Horse Pike
Egg Hbr Twp, NJ 08234
Phone (609) 272-0909

6550 Delilah Rd
Ste 301
Egg Hbr Twp, NJ 08234
Phone (609) 573-1251

2500 English Creek Ave
Ste 800
Egg Hbr Twp, NJ 08234
Phone (609) 407-2277

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1500 Lansdowne Ave
Darby, PA 19023
Phone (610) 237-4561

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

342 W Germantown Pike
Ste 310
Norristown, PA 19403
Phone (610) 270-2409

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

Interoperability endpoints

  • Direct secure messaging: pshah525476@direct-ehr-ssmhc.com
  • Direct secure messaging: pshah57869@albanymed.direct-ci.com
  • Direct secure messaging: pooja.shahmd.p1@direct.cfg.nextgenshare.com

Organizations & group practices 33

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.

View all 33

Hospital & facility affiliations 5

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1083077903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "219-866-5141",
            "fax_number": "708-679-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 S Bryn Mawr Ave",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103121",
            "country_code": "US",
            "telephone_number": "888-227-3898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WI",
            "postal_code": "535661569",
            "country_code": "US",
            "telephone_number": "608-324-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "POOJA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "4878",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD468674",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA11569300",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MT217563",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036172040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pshah525476@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pshah525476@direct-ehr-ssmhc.com",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.