Gautam Vinod Shah, M.D

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35.136566 Issued in OH

Practice address

20455 Lorain Rd FL 2
Fairview Park, OH 44126

Phone

(216) 408-1044

NPI assigned

Aug 15, 2013

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 OH

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairview Hospital Hospital, Cleveland, OH, CCN 360077
• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
• Euclid Hospital Hospital, Euclid, OH, CCN 360082
• Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Wooster Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Wooster, OH
  • NPI 1033135009
  Medicare reassignment Care Compare group NPD
• Clinic Medical Services Company LLC

  • Diagnostic Radiology Physician
  • Cleveland, OH
  • NPI 1528013984
  Medicare reassignment NPD
• Clinic Medical Services Company

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1508024209
  NPD

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

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017
  Care Compare affiliation
• Cleveland Clinic Health System - East Region

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1598719346
  Care Compare affiliation
• Cleveland Clinic Health System - East Region

  • General Acute Care Hospital
  • Mayfield HTS, OH
  • NPI 1902858152
  Care Compare affiliation
• Fairview Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1215989611
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1265865034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD FL 2",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263530",
            "telephone_number": "216-408-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20455 LORAIN RD FL 2",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "44126",
            "telephone_number": "216-408-1044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "First Avenue at 16th street",
            "address_2": "Cardiovascular Services Silver Building Room 4S09A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10003",
            "country_code": "US",
            "telephone_number": "212-420-2876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "GAUTAM",
        "middle_name": "VINOD",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.136566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Sciarappa
• Scoggins Dialysis LLC
• Shane Seipel, M.D.
• Stephanie Seldon
• William Seldon Jr., LMT
• Mohamed M Shahed, MD
• Navneet Sharma, M.D,
• Jennifer Elizabeth Sheridan, M.A. CCC/SLP
• Sarah Anne Sherwood, DPT
• Patricia L Shimko, OTR/L

• Cardiovascular Disease Physician in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.