Syed Sheheryar Ahmed Shah, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

E-16280 Issued in AR

Practice address

1420 W 43Rd Ave Ste a
Pine Bluff, AR 71603-7010

Phone

(870) 541-6020

Fax

(870) 541-6021

NPI assigned

Jul 4, 2018

Last updated

Jul 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Nephrology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson Hospital Association, IncGroup PAC ID 8123927431, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usrc Pine Bluff Dialysis facility, Pine Bluff, AR, CCN 042564
• Fmcna - Pine Bluff Dialysis facility, Pine Bluff, AR, CCN 042532
• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
• Baptist Health Medical Center-Drew County Hospital, Monticello, AR, CCN 040051
• Dewitt Hospital & Nursing Home, Inc Hospital, De Witt, AR, CCN 040783
• Bradley County Medical Center Hospital, Warren, AR, CCN 041327

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.

• Jefferson Hospital Association, Inc

  • Pulmonary Disease Physician
  • Pine Bluff, AR
  • NPI 1932157674

  Nephrology

  Medicare reassignment Care Compare group NPD
• Jefferson Hospital Assn, Inc.

  dba Surgical Associates of Southeast Arkansas

  • Surgery Physician
  • Pine Bluff, AR
  • NPI 1962753574
  NPD
• Jefferson Hospital Association, Inc

  • Rural Health Clinic/Center
  • Crossett, AR
  • NPI 1225799646
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson County Dialysis, Inc.

  dba Fresenius Medical Care Pine Bluff Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pine Bluff, AR
  • NPI 1467564369

  Dialysis facility

  Care Compare affiliation Name & address match
• Pine Bluff Dialysis Inc

  dba Pine Bluff - US Renal Care

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Pine Bluff, AR
  • NPI 1073590923

  Dialysis facility

  Care Compare affiliation Name & address match
• Baptist Health

  dba Baptist Health Medical Center - Drew County

  • General Acute Care Hospital
  • Monticello, AR
  • NPI 1962283192
  Care Compare affiliation
• Bradley County Medical Center

  • Critical Access Hospital
  • Warren, AR
  • NPI 1194741611
  Care Compare affiliation
• Dewitt Hospital & Nursing Home, Inc.

  • Rural Acute Care Hospital
  • De Witt, AR
  • NPI 1972586238
  Care Compare affiliation
• Jefferson Hospital Association Inc

  dba Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1174019905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716132650",
            "telephone_number": "870-541-7211",
            "fax_number": "870-541-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 43RD AVE STE A",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037010",
            "telephone_number": "870-541-6020",
            "fax_number": "870-541-6021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Spring Avenue, SLUCare Academic Pavilion",
            "address_2": "Room 2418",
            "address_purpose": "LOCATION",
            "city": "St Louis",
            "state": "MO",
            "postal_code": "63110",
            "country_code": "US",
            "telephone_number": "314-977-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Stanton L Young Blvd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045018",
            "country_code": "US",
            "telephone_number": "405-271-5963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SYED SHEHERYAR AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-04",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "33819",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2021011606",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E-16280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SCPG Arkansas LLC (Express Rx of Pine Bluff)
• SCPG Arkansas LLC (Express Rx of Pine Bluff)
• Jordan Alyssa Scribner
• Mason Charles Seelinger, O.D.
• Jainil Jatin Shah, M.D.
• Tabeer Shaikh, M.D.
• Neha Sharma
• Jazzmine Shavers
• Sameer R. Shelat, M.D.
• Mickey K. Shell, MS

• Nephrology Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Nephrology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.