Dipak S. Shah, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036-054079 Issued in IL

Practice address

615 Valley View Dr.
Suite 202
Moline, IL 61265-6180

Phone

(309) 762-1072

Fax

(309) 762-1094

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Dipak S. Shah Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Metro MRI Center Limited Partnership

  • Radiology Clinic/Center
  • Moline, IL
  • NPI 1205812831
  NPD (past)
• Quint Cities Radiation Oncology, LTD

  • Radiation Oncology Physician
  • Moline, IL
  • NPI 1992750459
  NPD (past)
• Ora Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Durant, IA
  • NPI 1639159700
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1154323574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 VALLEY VIEW DR.",
            "address_2": "SUITE 202",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656180",
            "telephone_number": "309-762-1072",
            "fax_number": "309-762-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 VALLEY VIEW DR.",
            "address_2": "SUITE 202",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656180",
            "telephone_number": "309-762-1072",
            "fax_number": "309-762-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DIPAK",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-054079",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "26429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIPAK",
            "last_name": "SHAH",
            "middle_name": "S.",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Secure Dental II
• Secure Dental VI
• Philip J Sepanski, LCPC
• David Victor Shaffer, D.C.
• Leslie Anne Shaffer, PHARMD
• Zacariah Shannon, D.C.
• Molly Shattuck, RD
• Jennifer Shaw, ARNP
• Maille Sheerin
• Elizabeth R Shelly, PT

• Diagnostic Radiology Physician in Moline, IL
• Providers in Moline, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.