NPIMap

Individual provider Active NPI

Prince Shah, M.D.

  • Gastroenterology Physician
  • Gilroy, CA
National Provider Identifier
1174632251
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A64458 Issued in CA
Practice address
9460 N Name Uno
Ste. 130
Gilroy, CA 95020-3537
Phone
(408) 848-8336
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A64458 CA Primary

Addresses

Primary practice location

9460 N Name Uno
Ste. 130
Gilroy, CA 95020-3537

Mailing address

9460 N Name Uno
Ste. 130
Gilroy, CA 95020-3537
Phone (408) 848-8336

Other identifiers 1

IdentifierTypeStateIssuer
00A644581MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070131000595 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 7012919210 Reassigns benefits to 2 organizations
Practice locations: Gilroy, CA

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9460 N Name Uno
Suite 130
Gilroy, CA 95020-3532
Phone (408) 848-8336

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy130
Upper gastrointestinal (GI) endoscopy for acid reflux96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A64458CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jun 3, 2021 Accepting new patients
Prince Shah MD a Medical Corporation Gastroenterology CurrentSince Nov 1, 2021 Accepting new patients
County of Santa Clara CurrentSince Jun 3, 2021 Accepting new patients
County of Santa Clara Current Accepting new patients
Gilroy Endoscopy Center LLC Current Accepting new patients
Ampla Health Past Accepting new patients
Ampla Health Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

9460 No Name Uno
Ste 130
Gilroy, CA 95020
Phone (408) 847-1311

9400 No Name Uno
Gilroy, CA 95020
Phone (408) 848-2000

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Interoperability endpoints

  • Direct secure messaging: pshah126221@santaclaravalley.direct-ci.net

Organizations & group practices 9

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 9

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1174632251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9460 N NAME UNO",
            "address_2": "STE. 130",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203537",
            "telephone_number": "408-848-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 N NAME UNO",
            "address_2": "STE. 130",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950203537",
            "telephone_number": "408-848-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRINCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A64458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A644581",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilroy, CA

Sources for this page

Verify at the official NPI Registry.