NPIMap

Individual provider Active NPI

Prashant C. Shah, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Temple, TX
National Provider Identifier
1164605994
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
Q5095 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-2111
Fax
(254) 724-7603
NPI assigned
Dec 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 242142 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 242142 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 234662 MA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD440865 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X Q5095 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pshah76073@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151020000987 TX Practitioner - Thoracic Surgery 8628136637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

239 W Business
190 Baylor Scott and White Clinic Coppe
Copperas Cove, TX 76522-2912
Phone (254) 542-9000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242142NYMDSurgery Physician
234662MAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Q5095TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Surgery CurrentSince Oct 5, 2015 Accepting new patients
Scott & White Clinic Surgery CurrentSince Oct 5, 2015 Accepting new patients
Scott & White Memorial Hospital Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: pshah76073@direct.sw.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1197676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1164605994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111",
            "fax_number": "254-724-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111",
            "fax_number": "254-724-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRASHANT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "242142",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "242142",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "234662",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD440865",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "Q5095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pshah76073@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.