Pooja Patel Shah, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY24456 Issued in CA

Practice address

932 Coletta Cir
Naperville, IL 60563-3615

Phone

(331) 444-2505

Fax

(331) 333-3903

NPI assigned

Jul 1, 2009

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Pooja Akshay Patel Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lifestancehealth.poojashah@146897.advancedmd-direct.com

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.

• Empowered Minds Today, PC

  • Psychologist
  • Naperville, IL
  • NPI 1104682129

  Clinical

  Medicare reassignment NPD Authorized official
• Pasadena Clinical Group, a Psychology Corporation

  • Psychologist
  • Pasadena, CA
  • NPI 1790213247

  Clinical

  NPD (past)

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1205064938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 COLETTA CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633615",
            "telephone_number": "331-444-2505",
            "fax_number": "331-333-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 COLETTA CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633615",
            "telephone_number": "331-444-2505",
            "fax_number": "331-333-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "POOJA",
        "middle_name": "PATEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009795",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "POOJA",
            "last_name": "PATEL",
            "middle_name": "AKSHAY",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jyoti Shah, D.O
• Kunal Shah, DPT
• Kushal Deepak Shah, M.D.
• Neha Shah, M.D.
• Nick Shah, MD
• Rachel Shah, PT, DPT
• Radhika Choksi Shah, MD
• Reshma M Shah, PHARM D
• Rohan Vikram Shah, DDS
• Sandhya Bharat Shah, RPH

• Clinical Psychologist in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.