NPIMap

Individual provider Active NPI

Rutvi Shah, MD

  • Family Medicine Physician
  • Stoughton, WI
National Provider Identifier
1154063550
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
82685-20 Issued in WI
Practice address
225 Church St
Stoughton, WI 53589-1801
Phone
(608) 877-2777
Fax
(608) 877-2774
NPI assigned
Apr 7, 2022
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 82685-20 WI Primary

Addresses

Primary practice location

225 Church St
Stoughton, WI 53589-1801

Mailing address

225 Church St
Stoughton, WI 53589-1801
Phone (608) 877-2777

Other identifiers 1

IdentifierTypeStateIssuer
1154063550MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022001225 WI Practitioner - Family Practice 7113307570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

225 Church St
Stoughton, WI 53589-1801
Phone (608) 877-2777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82685-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc Family Medicine CurrentSince Oct 10, 2025 Accepting new patients
Dean Health Systems, Inc. CurrentSince Oct 10, 2025 Accepting new patients

Locations

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

225 Church St
Stoughton, WI 53589
Phone (608) 877-2700

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 7

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": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1154063550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CHURCH ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891801",
            "telephone_number": "608-877-2777",
            "fax_number": "608-877-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CHURCH ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891801",
            "telephone_number": "608-877-2777",
            "fax_number": "608-877-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RUTVI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "82685-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154063550",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

Verify at the official NPI Registry.