Active NPI
Kantilal J. Shah, M.D.
- Family Medicine Physician
- Phila, PA
National Provider Identifier
1245341247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD035821L
- Practice address
- 2701 N Broad St
Phila, PA 19132-2743 - Phone
- (215) 226-8800
- Fax
- (215) 226-8819
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD035821L | PA | Primary |
Addresses
Primary practice location
2701 N Broad St
Phila, PA 19132-2743
Mailing address
PO Box 820933
Philadelphia, PA 19182-0933
Phone (215) 926-9010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000612210 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Physicians Inc | Family Medicine | Past | Accepting new patients |
| Temple Physician Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Feasterville Trevose, PA
- NPI 1174497366
-
- Family Medicine Physician
- Flourtown, PA
- NPI 1952642936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1245341247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 820933",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191820933",
"telephone_number": "215-926-9010",
"fax_number": "215-226-8285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 N BROAD ST",
"city": "PHILA",
"state": "PA",
"postal_code": "191322743",
"telephone_number": "215-226-8800",
"fax_number": "215-226-8819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KANTILAL",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD035821L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000612210",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.