Individual provider Active NPI

Bhanu J Shah, MD

  • Obstetrics & Gynecology Physician
  • Sterling Heights, MI
National Provider Identifier
1295743896
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
31534 Issued in MI
Practice address
37300 Dequindre Rd Ste 115
Sterling Heights, MI 48310
Phone
(586) 574-2190
Fax
(586) 574-2203
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 31534 MI Primary

Addresses

Primary practice location

37300 Dequindre Rd Ste 115
Sterling Heights, MI 48310

Mailing address

37300 Dequindre Rd Ste 115
Sterling Heights, MI 48310-3508
Phone (586) 574-2190

Other practice location 1

37300 Dequindre Rd Ste 115
Sterling Heights, MI 48310
Phone (586) 574-2190

Other identifiers 1

IdentifierTypeStateIssuer
105976410MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100220000116 MI Practitioner - Obstetrics/Gynecology 2567506165 Practice locations: Sterling Heights, MI

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1962
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

37300 Dequindre Rd
Suite 115
Sterling Heights, MI 48310-3508
Phone (586) 574-2190

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31534MIMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: bshah1150888@direct.hfhs.org
  • Direct secure messaging: bhanu.shah@directaddress.net

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1295743896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37300 DEQUINDRE RD STE 115",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103508",
            "telephone_number": "586-574-2190",
            "fax_number": "586-574-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37300 DEQUINDRE RD STE 115",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48310",
            "telephone_number": "586-574-2190",
            "fax_number": "586-574-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37300 Dequindre Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "48310",
            "country_code": "US",
            "telephone_number": "586-574-2190",
            "fax_number": "586-574-2203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BHANU",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "31534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105976410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.