Shahab M Ehtesham, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101225223 Issued in VA

Practice address

611 Trent St NE
Norton, VA 24273-1533

Phone

(276) 679-4200

Fax

(276) 679-4230

NPI assigned

Apr 11, 2006

Last updated

Jun 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY, VA2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pikeville Medical Center Hospital, Pikeville, KY, CCN 180044
• Tug Valley Arh Regional Medical Center Hospital, South Williamson, KY, CCN 180069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sehtesham46242@pikevillekydirect.org

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.

• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864
  Medicare reassignment Care Compare group NPD
• RMH Medical Group LLC

  dba Sentara RMH Medical Group

  • General Practice Physician
  • Rockingham, VA
  • NPI 1669844908
  Medicare reassignment NPD
• Shahab M. Ehtesham MD PLLC

  • Internal Medicine Physician
  • Norton, VA
  • NPI 1184804163
  Authorized official Same address or phone
• RMH Medical Group LLC

  • Customized Equipment (DME)
  • Harrisonburg, VA
  • NPI 1043238967
  NPD
• Pikeville Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Cheyenne, WY
  • NPI 1891599502
  NPD
• Uzma Ehtesham MD PLLC

  • Psychiatry Physician
  • Norton, VA
  • NPI 1073793055
  NPD (past)
• Appalachian Regional Healthcare, Inc

  dba Hazard ARH Regional Medical Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Hazard, KY
  • NPI 1780728881
  NPD (past)
• Jenkins Community Hospital Dba Jenkins Community Hospital

  • Clinic/Center
  • Elkhorn City, KY
  • NPI 1922143213
  NPD (past)
• Parkway Medical Clinic

  • Family Medicine Physician
  • Manchester, KY
  • NPI 1992965032
  NPD (past)
• Pikeville Medical Center Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Whitesburg, KY
  • NPI 1871575498
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

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

• Appalachian Regional Healthcare, Inc.

  dba Tug Valley ARH Regional Medical Center

  • General Acute Care Hospital
  • South Williamson, KY
  • NPI 1649270257
  Care Compare affiliation
• Pikeville Medical Center Inc

  • General Acute Care Hospital
  • Pikeville, KY
  • NPI 1285621623
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1144283029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "city": "WISE",
            "state": "VA",
            "postal_code": "24293",
            "telephone_number": "276-679-4200",
            "fax_number": "276-679-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 TRENT ST NE",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731533",
            "telephone_number": "276-679-4200",
            "fax_number": "276-679-4230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1790 E Market St Ste 64B",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228015197",
            "country_code": "US",
            "telephone_number": "540-564-5666",
            "fax_number": "844-501-7984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "911 Bypass Rd Bldg A",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "415011602",
            "country_code": "US",
            "telephone_number": "606-430-3500",
            "fax_number": "606-218-4697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EHTESHAM",
        "first_name": "SHAHAB",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "32845",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101225223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010287669",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sehtesham46242@PIKEVILLEKYDIRECT.ORG",
            "affiliation": "N",
            "endpointDescription": "Direct address for ccda",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Standard Direct Functionality",
            "address_1": "911 Bypass Rd Bldg A",
            "city": "Pikeville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "415011602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Norton, VA
• Providers in Norton, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.