Individual provider Active NPI

Ashish Prabodh Shah, M.D.

  • Gastroenterology Physician
  • Raleigh, NC
National Provider Identifier
1083645477
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2015-00288 Issued in NC
Practice address
3024 New Bern Ave
Raleigh, NC 27610-1247
Phone
(919) 350-5318
Fax
(919) 350-7093
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C1-0007922 DE
Gastroenterology Physician 207RG0100X 2015-00288 NC Primary

Addresses

Primary practice location

3024 New Bern Ave
Raleigh, NC 27610-1247

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490

Other identifiers 1

IdentifierTypeStateIssuer
1083645477MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashah312703@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200629002201 NC Practitioner - Gastroenterology 4880691815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of New York at Stony Brook, School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians
Raleigh Medical Group PAGroup PAC ID 6800874322, 99 clinicians

Practice addresses (Care Compare)

3024 New Bern Ave
Raleigh, NC 27610-1247
Phone (919) 350-7856

530 New Waverly PL
Suite 200
Cary, NC 27518-7414
Phone (919) 859-5955

Hospital & facility affiliations

  • Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy94
Upper gastrointestinal (GI) endoscopy for acid reflux89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-00288NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Gastroenterology CurrentSince Aug 17, 2020 Accepting new patients
Wakemed Specialists Group, LLC Gastroenterology Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 17, 2020 Accepting new patients
Raleigh Medical Group, PA Gastroenterology CurrentSince Aug 1, 2023 Accepting new patients
Central Delaware Endoscopy Unit PastSince Sep 24, 1996 Accepting new patients

Locations

530 New Waverly Pl
Ste 200
Cary, NC 27518
Phone (919) 859-5955

2601 Lake Dr
Ste 201
Raleigh, NC 27607
Phone (919) 783-4888

3024 New Bern Ave
Ste 307
Raleigh, NC 27610
Phone (919) 350-7231

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

3024 New Bern Ave
Ste 101
Raleigh, NC 27610
Phone (919) 350-5318

3521 Haworth Dr
Raleigh, NC 27609
Phone (919) 782-1806

2920 Highwoods Blvd
Raleigh, NC 27604

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2600 Atlantic Ave
Raleigh, NC 27604
Phone (919) 881-9999

Interoperability endpoints

  • Direct secure messaging: ashah312703@directhisp.wakemed.org

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 2

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": "1618272000000",
    "number": "1083645477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-5318",
            "fax_number": "919-350-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ASHISH",
        "middle_name": "PRABODH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "DE",
            "license": "C1-0007922",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2015-00288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083645477",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashah312703@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "3024 New Bern Ave",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.