Individual provider Active NPI

Sayed Mustafa Mahmood Shah, M.B.B.S

  • Neurology Physician
  • Columbia, MO
National Provider Identifier
1194401398
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2023022085 Issued in MO
Practice address
1 Hospital Dr # Ce513
Columbia, MO 65212-1000
Phone
(573) 882-5092
Fax
(573) 884-4249
NPI assigned
Jun 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2023022085 MO Primary

Addresses

Primary practice location

1 Hospital Dr # Ce513
Columbia, MO 65212-1000

Mailing address

1 Hospital Dr # Ce513
Columbia, MO 65212-1000
Phone (573) 882-5092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230807002715 MO Order and Referring Only - NeurologyPractitioner - Neurology 2860853801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023022085MOMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1194401398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # CE513",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-882-5092",
            "fax_number": "573-884-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # CE513",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-882-5092",
            "fax_number": "573-884-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAYED MUSTAFA",
        "middle_name": "MAHMOOD",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2023022085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.