Deep Shah, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

073484 Issued in GA

Practice address

1289 Scenic Hwy
Lawrenceville, GA 30045-6358

Phone

(770) 972-9000

Fax

(770) 736-0556

NPI assigned

Apr 17, 2013

Last updated

Jan 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal Medicine

Education

Harvard Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gwinnett Clinic, LTDGroup PAC ID 9436061801, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: deep.shah.1@32352.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gwinnett Clinic LTD

  dba Gwinnett Clinic

  • Multi-Specialty Clinic/Center
  • Duluth, GA
  • NPI 1629117650
  Medicare reassignment Care Compare group NPD Authorized official
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Dacula, GA
  • NPI 1467463885

  Internal Medicine

  NPD Authorized official
• Gwinnett Clinic, LTD

  dba Gwinnett Clinic

  • Multi-Specialty Clinic/Center
  • Suwanee, GA
  • NPI 1528212149

  Internal Medicine

  NPD Authorized official
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Lawrenceville, GA
  • NPI 1134132921
  Authorized official Same address or phone
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Loganville, GA
  • NPI 1255342630

  Internal Medicine

  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate Good Samaritan Hospital

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1114361458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 MEDLOCK BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 SCENIC HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456358",
            "telephone_number": "770-972-9000",
            "fax_number": "770-736-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Lawrenceville Suwanee Rd",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300244918",
            "country_code": "US",
            "telephone_number": "678-205-5000",
            "fax_number": "678-240-2080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 Philip Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300468736",
            "country_code": "US",
            "telephone_number": "770-995-3300",
            "fax_number": "770-995-3307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2764 Main St W",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300785708",
            "country_code": "US",
            "telephone_number": "770-978-3388",
            "fax_number": "770-978-0807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "073484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolette Nari Shackelford-Martin, LPC
• Ruth-Ann Samantha Shackleford
• Camille Elyse Shaffer, LMSW
• Farina Shafqat, MD
• Shah Pediatrics,Inc
• Indra C Shah
• Jayendrakumar J Shah, MD
• Karan R Shah, PHARMD
• Kirti K Shah, MD
• Mahendra Ratilal Shah, MD

• Internal Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.