Individual provider Active NPI

Radhika Shah, FNP-BC

  • Primary Care Nurse Practitioner
  • Troy, MI
National Provider Identifier
1184338535
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704279608NSA2213H Issued in MI
Practice address
500 Kirts Blvd Ste 100
Troy, MI 48084-4135
Phone
(248) 824-6060
Fax
(248) 686-0772
NPI assigned
Jan 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704279608NSA2213H MI Primary

Addresses

Primary practice location

500 Kirts Blvd Ste 100
Troy, MI 48084-4135

Mailing address

PO Box 639295 Dept 93394
Cincinnati, OH 45263-9295
Phone (484) 346-1692

Other practice location 1

2833 Briarwood Dr
Troy, MI 48085-1153
Phone (248) 763-3993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230321000271 MI Practitioner - Nurse Practitioner 2365816063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Physician Care PCGroup PAC ID 8820442569, 2 clinicians

Practice addresses (Care Compare)

801 W Big Beaver Rd
Suite 300
Troy, MI 48084-4725
Phone (248) 515-4735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704279608NSA2213HMIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Mar 16, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Mar 16, 2023 Accepting new patients
Post Acute Physician Care PC CurrentSince Dec 12, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

801 W Big Beaver Rd
Ste 300
Troy, MI 48084
Phone (248) 658-8424

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1184338535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295 DEPT 93394",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "484-346-1692",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "248-824-6060",
            "fax_number": "248-686-0772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2833 Briarwood Dr",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851153",
            "country_code": "US",
            "telephone_number": "248-763-3993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RADHIKA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704279608NSA2213H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.