Active NPI
Birva K Shah, O.D.
- Optometrist
- Chicago Ridge, IL
National Provider Identifier
1134481211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010543
- Practice address
- 10436 Southwest Hwy
Suite 101
Chicago Ridge, IL 60415-2282 - Phone
- (708) 423-4192
- Fax
- (708) 952-0329
- NPI assigned
- Jun 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046010543 | IL | Primary |
| Pediatric Optometrist | 152WP0200X | 046010543 | IL |
Addresses
Primary practice location
10436 Southwest Hwy
Suite 101
Chicago Ridge, IL 60415-2282
Mailing address
4684 Dept
Carol Stream, IL 60122-4684
Phone (708) 423-4192
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01621679 | Other | IL | BLUE CROSS & BLUE SHEILD ESC # 01621679 |
| 200871680 | Other | IN | INDIANA GROUP MEDICAID LEGACY PTAN # 200871680 |
| 046010543 | Medicaid | IL | |
| 1083684922 | Other | IN | THE EYE SPECIALISTS CENTER, LLC GROUP NPI 1083684922 |
| 1700191012 | Other | IL | UNIVERSITY OF CHICAGO MEDICAL CENTER NPI |
| CK7818 | Other | IL | RAILROAD MEDICARE ESC GROUP# CK7818 |
| 1083684922 | Other | IL | THE EYE SPECIALISTS CENTER, LLC GROUP NPI 1083684922 |
| 12385422 | Other | IL | CAQH |
| 1699802421 | Other | IL | OPTICAL THE EYE SPECIALISTS CENTER, LLC GROUP NPI 1699802421 |
| 502720062 | Other | IL | MEDICARE PTAN |
| 14D2054175 | Other | IL | CLIA # 14D2054175 EXP 2-14-2015 CHICAGO RIDGE LOCATION |
| 253350 | Other | IN | INDIANA MEDICARE GROUP PTAN 253350 |
| 253350 | Other | IL | ILLINOIS MEDICARE GROUP PTAN 253350 |
| 6180260001 | Other | IL | DEMERC SUPPLIER PTAN 6180260001 THE EYE SPECIALISTS CENTER, LLC |
Other names 1
- Birva A Kadakia
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382054400000",
"number": "1134481211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4684 DEPT",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601224684",
"telephone_number": "708-423-4192",
"fax_number": "708-952-0329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10436 SOUTHWEST HWY",
"address_2": "SUITE 101",
"city": "CHICAGO RIDGE",
"state": "IL",
"postal_code": "604152282",
"telephone_number": "708-423-4192",
"fax_number": "708-952-0329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "BIRVA",
"middle_name": "K",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-13",
"last_updated": "2013-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010543",
"primary": true
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "IL",
"license": "046010543",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHEILD ESC # 01621679",
"identifier": "01621679",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA GROUP MEDICAID LEGACY PTAN # 200871680",
"identifier": "200871680",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046010543",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE EYE SPECIALISTS CENTER, LLC GROUP NPI 1083684922",
"identifier": "1083684922",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY OF CHICAGO MEDICAL CENTER NPI",
"identifier": "1700191012",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE ESC GROUP# CK7818",
"identifier": "CK7818",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE EYE SPECIALISTS CENTER, LLC GROUP NPI 1083684922",
"identifier": "1083684922",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12385422",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTICAL THE EYE SPECIALISTS CENTER, LLC GROUP NPI 1699802421",
"identifier": "1699802421",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "502720062",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA # 14D2054175 EXP 2-14-2015 CHICAGO RIDGE LOCATION",
"identifier": "14D2054175",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA MEDICARE GROUP PTAN 253350",
"identifier": "253350",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS MEDICARE GROUP PTAN 253350",
"identifier": "253350",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEMERC SUPPLIER PTAN 6180260001 THE EYE SPECIALISTS CENTER, LLC",
"identifier": "6180260001",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BIRVA",
"last_name": "KADAKIA",
"middle_name": "A",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chicago Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.