Rahul Chaitanya Shah

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501019723 Issued in MI

Practice address

6160 Snyder Rd
Berrien Springs, MI 49103-9670

Phone

(269) 759-0072

NPI assigned

Sep 7, 2020

Last updated

Jan 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment Care Compare group NPD
• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399
  Medicare reassignment NPD
• Ivyrehab Network Inc

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1861623753
  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD
• Pro-Line Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Southfield, MI
  • NPI 1578176269
  NPD (past)

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1255945226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 SNYDER RD",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039670",
            "telephone_number": "269-759-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 SNYDER RD",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039670",
            "telephone_number": "269-759-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAHUL",
        "middle_name": "CHAITANYA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-07",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Diane Schmidtmcclintock, MSW LLSW
• David Herbert Schug, BS RPH
• Kevin Seo, MD
• Robert Sepulveda, LPC
• Kathleen Joann Shafer, LMSW
• Shangrila Home
• Lars Sherburn
• Jane Anne Sherwin, RN
• Crystal Smeal
• Chana Ione Smith, PT

• Physical Therapist in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.