Individual provider Active NPI

Selina Shah, MD

  • Sports Medicine (Internal Medicine) Physician
  • Walnut Creek, CA
National Provider Identifier
1205995958
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
A83067 Issued in CA
Practice address
2255 Ygnacio Valley Rd Ste V
Walnut Creek, CA 94598-3343
Phone
(925) 979-5327
Fax
(925) 357-3199
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X A83067 CA Primary

Addresses

Primary practice location

2255 Ygnacio Valley Rd Ste V
Walnut Creek, CA 94598-3343

Mailing address

2255 Ygnacio Valley Rd Ste V
Walnut Creek, CA 94598-3343
Phone (925) 979-5327

Other identifiers 1

IdentifierTypeStateIssuer
A83067OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050228000216 CA Practitioner - Sports MedicinePractitioner - Internal MedicinePractitioner - Other (Physician) 1254384563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Internal Medicine
Education
Vanderbilt University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

1505 Saint Alphonsus Way
Alamo, CA 94507-1570
Phone (925) 932-6330

2255 Ygnacio Valley Rd
Walnut Creek, CA 94598-3343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as apm
Quality
80.39
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83067CAMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Nov 1, 2017 Accepting new patients
Bass Medical Group Current Accepting new patients
Bass Medical Group CurrentSince Nov 1, 2017 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

2255 Ygnacio Valley Rd
Ste V
Walnut Creek, CA 94598
Phone (925) 448-2610

365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424

2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sshah112617@ehr.johnmuirhealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1205995958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE V",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983343",
            "telephone_number": "925-979-5327",
            "fax_number": "925-357-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE V",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983343",
            "telephone_number": "925-979-5327",
            "fax_number": "925-357-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SELINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "CA",
            "license": "A83067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A83067",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.