Individual provider Active NPI

Shanil Shah, MD

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1154974145
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME165027 Issued in FL
Practice address
St Vincent Hospital, Department of Internal Medicine
123 Summer Street
Worcester, MA 01608
Phone
(508) 363-5000
NPI assigned
Jul 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME165027 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X 280508 MA

Addresses

Primary practice location

St Vincent Hospital, Department of Internal Medicine
123 Summer Street
Worcester, MA 01608

Mailing address

1936 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9262
Phone (352) 307-9925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL2 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
I20221111001434 MA Practitioner - Internal Medicine 5890162309 Reassigns benefits to 2 organizations
I20240229002879 FL Practitioner - Internal Medicine 5890162309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Physicians of Massachusetts PCGroup PAC ID 4183038359, 84 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-9394

Merit-based Incentive Payment System (MIPS)

Final score
84.3 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280508MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Physicians of Massachusetts PC Internal Medicine CurrentSince Jul 28, 2022 Accepting new patients
Physicians of Cape Cod Hospital Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Physicians of Mid Florida LLC CurrentSince Jan 27, 2024 Accepting new patients

Locations

1936 Bruce B Downs Blvd
Wesley Chapel, FL 33544
Phone (352) 350-3440

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 3

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": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1154974145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335449262",
            "telephone_number": "352-307-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST VINCENT HOSPITAL, DEPARTMENT OF INTERNAL MEDICINE",
            "address_2": "123 SUMMER STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-363-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHANIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME165027",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "280508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.