Individual provider Active NPI

Birju Anilkumar Shah, M.D., M.P.H.

  • Neonatal-Perinatal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1174894919
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
31249 Issued in OK
Practice address
1200 Everett Dr
Etnp 7504
Oklahoma City, OK 73104-5047
Phone
(405) 271-5215
Fax
(405) 271-1236
NPI assigned
Jan 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD13826 RI
Neonatal-Perinatal Medicine Physician 2080N0001X 31249 OK Primary

Addresses

Primary practice location

1200 Everett Dr
Etnp 7504
Oklahoma City, OK 73104-5047

Mailing address

1200 Everett Dr
Etnp 7504
Oklahoma City, OK 73104-5047
Phone (405) 271-5215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20150806010821 OK Practitioner - Pediatric MedicinePractitioner - Other (Physician) 2769635648 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31249OKMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2015 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2015 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Ted Jeffers Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

1200 Everett Dr
Fl 7
Oklahoma City, OK 73104
Phone (405) 271-5215

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

1200 Everett Dr
#7504
Oklahoma City, OK 73104
Phone (405) 271-5215

1200 Childrens Ave
Ste 5D
Oklahoma City, OK 73104
Phone (405) 271-4211

Interoperability endpoints

  • Direct secure messaging: bshah29641@ouhealth.direct-ci.net

Organizations & group practices 7

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": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1174894919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EVERETT DR",
            "address_2": "ETNP 7504",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045047",
            "telephone_number": "405-271-5215",
            "fax_number": "405-271-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EVERETT DR",
            "address_2": "ETNP 7504",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045047",
            "telephone_number": "405-271-5215",
            "fax_number": "405-271-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BIRJU",
        "middle_name": "ANILKUMAR",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD13826",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OK",
            "license": "31249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.