Individual provider Active NPI

Shirish A Amin, MD

  • Gastroenterology Physician
  • Indiana, PA
National Provider Identifier
1114903994
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD050640L Issued in PA
Practice address
1265 Wayne Ave
119 Professional Center, Suite 301
Indiana, PA 15701-3501
Phone
(724) 465-6650
Fax
(724) 357-9281
NPI assigned
Dec 22, 2005
Last updated
Nov 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD050640L PA Primary
Hepatology Physician 207RI0008X MD050640L PA

Addresses

Primary practice location

1265 Wayne Ave
119 Professional Center, Suite 301
Indiana, PA 15701-3501

Mailing address

1265 Wayne Ave
119 Professional Center, Suite 301
Indiana, PA 15701-3501
Phone (724) 465-6650

Other identifiers 1

IdentifierTypeStateIssuer
00019110080002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040902000227 PA Practitioner - Gastroenterology 1355316233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1265 Wayne Ave
Indiana, PA 15701-3501
Phone (724) 465-6650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.16 of 100Reported as individual
Quality
58.07
Improvement activities
40
Cost
73.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy103
Upper gastrointestinal (GI) endoscopy for acid reflux94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD050640LPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Center of Indiana, P.C. CurrentSince Dec 17, 2004 Accepting new patients
Shirish a. Amin M.D., P.C. Gastroenterology CurrentSince Jan 1, 2002 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1265 Wayne Ave
Ste 119
Indiana, PA 15701
Phone (724) 349-3233

1265 Wayne Ave
Ste 301
Indiana, PA 15701
Phone (724) 465-6650

1265 Wayne Ave
Ste 301
Indiana, PA 15701
Phone (724) 465-6384

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1114903994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE",
            "address_2": "119 PROFESSIONAL CENTER, SUITE 301",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-465-6650",
            "fax_number": "724-357-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE",
            "address_2": "119 PROFESSIONAL CENTER, SUITE 301",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-465-6650",
            "fax_number": "724-357-9281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "SHIRISH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD050640L",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "PA",
            "license": "MD050640L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00019110080002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.