Individual provider Active NPI

Perini Shah, D.O.

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1144633819
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017023058 Issued in MO
Practice address
12700 Southfork Rd Ste 215
Saint Louis, MO 63128-3276
Phone
(314) 543-5244
Fax
(314) 543-5248
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2014016673 MO
Family Medicine Physician 207Q00000X 2017023058 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 215
Saint Louis, MO 63128-3276

Mailing address

12700 Southfork Rd Ste 215
Saint Louis, MO 63128-3276
Phone (314) 543-5244

Other practice location 1

615 S New Ballas Rd
Family Medicine
Saint Louis, MO 63141-8221
Phone (314) 251-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20170807002803 MO Practitioner - Family Practice 8325265895 Reassigns benefits to 1 organization
I20200826001327 TX Practitioner - Family Practice 8325265895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3800 Gaylord Pkwy
Suite 910
Frisco, TX 75034-9419
Phone (469) 800-7560

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 3, 2020 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Aug 3, 2020 Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

9735 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127
Phone (314) 525-1887

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

5425 Southfield Ctr
Saint Louis, MO 63123
Phone (314) 543-5258

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3800 Gaylord Pkwy
Ste 910
Frisco, TX 75034
Phone (469) 800-4080

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: pshah700379@direct.sw.org

Organizations & group practices 6

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

Hospital & facility affiliations 5

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144633819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 215",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283276",
            "telephone_number": "314-543-5244",
            "fax_number": "314-543-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 215",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283276",
            "telephone_number": "314-543-5244",
            "fax_number": "314-543-5248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 S New Ballas Rd",
            "address_2": "Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418221",
            "country_code": "US",
            "telephone_number": "314-251-8888",
            "fax_number": "314-251-8889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PERINI",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2014016673",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017023058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.