NPIMap

Individual provider Active NPI

Mitul B Shah, M.D.

  • Obstetrics & Gynecology Physician
  • Saint Louis, MO
National Provider Identifier
1083645436
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
111027 Issued in MO
Practice address
1031 Bellevue Ave
Suite 400
Saint Louis, MO 63117-1818
Phone
(314) 977-7455
Fax
(314) 977-7477
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 111027 MO Primary

Addresses

Primary practice location

1031 Bellevue Ave
Suite 400
Saint Louis, MO 63117-1818

Mailing address

6420 Clayton Rd
Suite 290
Saint Louis, MO 63117-1811
Phone (314) 781-1505

Other identifiers 1

IdentifierTypeStateIssuer
20509400MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20060728000221 MO Practitioner - Obstetrics/Gynecology 3870506314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1031 Bellevue Ave
Suite 280a
Saint Louis, MO 63117-1818
Phone (314) 977-7455

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8208

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Health Care Group Obstetrics & Gynecology CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

6420 Clayton Rd
Ste 290
Saint Louis, MO 63117
Phone (314) 781-1505

Interoperability endpoints

  • Direct secure messaging: mshah19713@direct-ehr-ssmhc.com

Organizations & group practices 5

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 3

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1083645436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "address_2": "SUITE 290",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-781-1505",
            "fax_number": "314-781-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 BELLEVUE AVE",
            "address_2": "SUITE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171818",
            "telephone_number": "314-977-7455",
            "fax_number": "314-977-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MITUL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "111027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20509400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.