Anish Sunderrajan Shah, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A84992 Issued in CA

Practice address

480 Tesconi Cir Ste B
Santa Rosa, CA 95401-4691

Phone

(707) 206-7268

Fax

(707) 206-7254

NPI assigned

Aug 20, 2007

Last updated

Feb 8, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Psychiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siyan Clinical CorporationGroup PAC ID 0042470122, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Siyan Clinical Corporation

  • Psychiatry Physician
  • Santa Rosa, CA
  • NPI 1568732972
  Medicare reassignment Care Compare group NPD Authorized official
• Department of State Hospitals

  dba Coalinga State Hospital

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Siyan Care Corporation

  • Substance Abuse Rehabilitation Facility
  • Santa Rosa, CA
  • NPI 1588323869
  Authorized official Same address or phone
• Siyan Clinical Research

  • Substance Abuse Rehabilitation Facility
  • Santa Rosa, CA
  • NPI 1093484834
  Authorized official Same address or phone
• Department of State Hospitals

  dba Department of State Hospitals-Atascadero

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Department of State Hospitals

  dba Department of State Hospitals - Napa

  • Psychiatric Hospital
  • Napa, CA
  • NPI 1326098161
  NPD

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1164615589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 TESCONI CIR STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014691",
            "telephone_number": "707-206-7268",
            "fax_number": "707-206-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 TESCONI CIR STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014691",
            "telephone_number": "707-206-7268",
            "fax_number": "707-206-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANISH",
        "middle_name": "SUNDERRAJAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A84992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SG Homecare, Inc
• Eiann Sha, PHARMD
• Susan M Shaddick, M.A., MFT
• Sharilyn Renae Shaeffer, MFT
• Anal A Shah, DPT
• Avni A Shah, MD
• Mansi R Shah, M.D.
• Paulomi A Shah, D.O.
• Raime Shah, DDS, MS
• Sagar Shah, DPM

• Psychiatry Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.