Individual provider Active NPI

Maulik Gautam Shah, M.D.

  • Cardiovascular Disease Physician
  • Scottsdale, AZ
National Provider Identifier
1154592061
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
41574 Issued in AZ
Practice address
16427 N Scottsdale Rd
Suite 100
Scottsdale, AZ 85254-8197
Phone
(480) 718-5072
Fax
(480) 718-5074
NPI assigned
Mar 19, 2008
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A80105 CA
Interventional Cardiology Physician 207RI0011X 41574 AZ
Nuclear Cardiology Physician 207UN0901X 41754 AZ
Cardiovascular Disease Physician 207RC0000X 41574 AZ Primary

Addresses

Primary practice location

16427 N Scottsdale Rd
Suite 100
Scottsdale, AZ 85254-8197

Mailing address

PO Box 13507
Scottsdale, AZ 85267-3507
Phone (480) 718-5072

Other practice location 1

7373 N Scottsdale Rd Ste B100
Scottsdale, AZ 85253
Phone (480) 718-5072

Other identifiers 1

IdentifierTypeStateIssuer
447809MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090818000270 AZ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9436137148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of California, San Francisco School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

7373 N Scottsdale Rd
Suite B120
Scottsdale, AZ 85253-3555
Phone (480) 718-5072

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A80105CAMDCardiovascular Disease Physician
41574AZMDInterventional Cardiology Physician
41754AZMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince Feb 1, 2021 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory CurrentSince Feb 1, 2021 Accepting new patients
Honorhealth Ambulatory Cardiovascular Disease Past Accepting new patients

Locations

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

16427 N Scottsdale Rd
Ste 100
Scottsdale, AZ 85254
Phone (480) 718-5072

3099 N Civic Center Plz
Scottsdale, AZ 85251
Phone (480) 945-3535

7373 N Scottsdale Rd
Ste B120
Scottsdale, AZ 85253
Phone (480) 718-5072

Interoperability endpoints

  • Direct secure messaging: mshah110672@direct.honorhealth.com

Organizations & group practices 5

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 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": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1154592061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13507",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852673507",
            "telephone_number": "480-718-5072",
            "fax_number": "480-718-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16427 N SCOTTSDALE RD",
            "address_2": "SUITE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852548197",
            "telephone_number": "480-718-5072",
            "fax_number": "480-718-5074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7373 N Scottsdale Rd Ste B100",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "85253",
            "country_code": "US",
            "telephone_number": "480-718-5072",
            "fax_number": "480-718-5074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MAULIK",
        "middle_name": "GAUTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A80105",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "41574",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "AZ",
            "license": "41754",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "41574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447809",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.