Individual provider Active NPI

Deepa M Shah, M.D.

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1184689937
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L0586 Issued in TX
Practice address
2400 Cedar Bend Dr
Austin, TX 78758-5378
Phone
(512) 901-4016
Fax
(512) 901-3857
NPI assigned
Apr 17, 2006
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L0586 TX
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X L0586 TX
Pediatrics Physician 208000000X L0586 TX Primary

Addresses

Primary practice location

2400 Cedar Bend Dr
Austin, TX 78758-5378

Mailing address

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-4937

Other identifiers 1

IdentifierTypeStateIssuer
030217602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080718000027 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1951474378 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Austin Diagnostic Clinic, PLLC Current Accepting new patients
Austin Diagnostic Clinic CurrentSince Jan 1, 2023 Accepting new patients
The Austin Diagnostic Clinic, PLLC Past Accepting new patients
Ascension Seton Past Accepting new patients
Austin Diagnostic Clinic, PA Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2400 Cedar Bend Dr
Austin, TX 78758
Phone (512) 901-4016

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Interoperability endpoints

  • Direct secure messaging: 11225-shaw-deepa@direct.leadingreach.com
  • Direct secure messaging: deepa.shah@hca8.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1184689937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4937",
            "fax_number": "512-901-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 CEDAR BEND DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585378",
            "telephone_number": "512-901-4016",
            "fax_number": "512-901-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DEEPA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L0586",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "L0586",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L0586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030217602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.