Individual provider Active NPI

Vipul Chandrahas Shah, M.D.

  • Ophthalmology Physician
  • Monroe, NC
National Provider Identifier
1174747059
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2013-01062 Issued in NC
Practice address
1632 E Roosevelt Blvd
Monroe, NC 28112-4017
Phone
(704) 295-3725
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME101111 FL
Ophthalmology Physician 207W00000X 2013-01062 NC Primary

Addresses

Primary practice location

1632 E Roosevelt Blvd
Monroe, NC 28112-4017

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other identifiers 1

IdentifierTypeStateIssuer
000569500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vshah5809@direct.ceenta.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20130726000650 NC Practitioner - Ophthalmology 2567554884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Florida College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1632 E Roosevelt Blvd
Monroe, NC 28112-4017
Phone (704) 295-3725

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Ophthalmology CurrentSince Aug 1, 2013 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA Ophthalmology CurrentSince Aug 1, 2013 Accepting new patients
St Lukes Cataract & Laser Institute Ophthalmology Past Accepting new patients

Locations

5933 Blakeney Park Dr
Ste 200
Charlotte, NC 28277
Phone (704) 295-3311

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

1632 E Roosevelt Blvd
Monroe, NC 28112
Phone (704) 295-3725

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1174747059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 E ROOSEVELT BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124017",
            "telephone_number": "704-295-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "VIPUL",
        "middle_name": "CHANDRAHAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME101111",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2013-01062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vshah5809@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "1632 E Roosevelt Blvd",
            "city": "Monroe",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281124017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.