Individual provider Active NPI

Tejas K Shah, MD

  • Pediatric Cardiology Physician
  • Dallas, TX
National Provider Identifier
1154322162
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
M8994 Issued in TX
Practice address
7777 Forest LN Ste B246
Dallas, TX 75230-6816
Phone
(972) 566-2043
Fax
(877) 563-1827
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

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
Pediatric Cardiology Physician 2080P0202X M8994 TX Primary
Pediatrics Physician 208000000X M8994 TX

Addresses

Primary practice location

7777 Forest LN Ste B246
Dallas, TX 75230-6816

Mailing address

7777 Forest LN Ste B246
Dallas, TX 75230-6816
Phone (972) 566-2043

Other practice location 1

9000 W Wisconsin Ave
Pediatric Cardiology
Milwaukee, WI 53226-4874
Phone (414) 266-6457

Other identifiers 1

IdentifierTypeStateIssuer
1154322162MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 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
I20100805000057 TX Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 3173568136 Reassigns benefits to 1 organization
I20260420001148 CO Practitioner - Pediatric Medicine 3173568136

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8994TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Cardiac Intensivists of North Texas PLLC Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
C. Ferrell Varner MD, Inc. Past Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients
Francis J. Fenaughty MD, P.C. Past Accepting new patients

Locations

7777 Forest Ln
Ste B246
Dallas, TX 75230
Phone (972) 566-7730

7777 Forest Ln
Ste C300J
Dallas, TX 75230
Phone (972) 566-2043

7777 Forest Ln
Ste B120
Dallas, TX 75230
Phone (972) 566-2525

Interoperability endpoints

  • Direct secure messaging: tejas.shah@hca7.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154322162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE B246",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306816",
            "telephone_number": "972-566-2043",
            "fax_number": "877-563-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE B246",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306816",
            "telephone_number": "972-566-2043",
            "fax_number": "877-563-1827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_2": "PEDIATRIC CARDIOLOGY",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264874",
            "country_code": "US",
            "telephone_number": "414-266-6457",
            "fax_number": "414-266-2294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TEJAS",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "M8994",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M8994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154322162",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.