Individual provider Active NPI

Kejal Shah, MD

  • Internal Medicine Physician
  • Wichita Falls, TX
National Provider Identifier
1124699525
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
V0159 Issued in TX
Practice address
1631 11TH St Unit B
Wichita Falls, TX 76301-4332
Phone
(940) 263-3000
Fax
(940) 263-3018
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X V0159 TX Primary

Addresses

Primary practice location

1631 11TH St Unit B
Wichita Falls, TX 76301-4332

Mailing address

1631 11TH St Unit B
Wichita Falls, TX 76301-4332
Phone (940) 263-3000

Other practice location 1

701 W 5th St Ste 1229
Odessa, TX 79763-4206
Phone (432) 703-5375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240812003353 TX Practitioner - Internal Medicine 6002354842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Magna Health PLLCGroup PAC ID 0749540045, 26 clinicians

Practice addresses (Care Compare)

1600 11TH St
Wichita Falls, TX 76301-4300
Phone (940) 263-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V0159TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Magna Health PLLC CurrentSince Jul 1, 2024 Accepting new patients
United Regional Health Care System Inc Current Accepting new patients

Locations

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

1631 11th St
Unit B
Wichita Falls, TX 76301
Phone (940) 263-3000

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: kshah77540@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 2

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 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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1124699525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 11TH ST UNIT B",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014332",
            "telephone_number": "940-263-3000",
            "fax_number": "940-263-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 11TH ST UNIT B",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014332",
            "telephone_number": "940-263-3000",
            "fax_number": "940-263-3018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W 5th St Ste 1229",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797634206",
            "country_code": "US",
            "telephone_number": "432-703-5375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KEJAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V0159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.