Individual provider Active NPI

Inaganti Mastan Shah, M.D.

  • Hematology & Oncology Physician
  • Omaha, NE
National Provider Identifier
1295829042
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
21140 Issued in NE
Practice address
6901 N 72ND St
Suite 2244
Omaha, NE 68122-1709
Phone
(402) 572-3535
Fax
(402) 572-2688
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 21140 NE Primary
Hematology & Oncology Physician 207RH0003X 33127 IA

Addresses

Primary practice location

6901 N 72ND St
Suite 2244
Omaha, NE 68122-1709

Mailing address

PO Box 641850
Omaha, NE 68164-7850
Phone (402) 572-3535

Other identifiers 5

IdentifierTypeStateIssuer
0538751MedicaidIA
47077065413MedicaidNE
830005301OtherNERAILROAD MEDICARE NORFOLK
P00325300OtherIARAILROAD MEDICARE
830007286OtherNERAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090409000124 NE Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3476619792 Reassigns benefits to 2 organizations
I20110406000147 IA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3476619792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

110 N 29TH St
Suite 1
Norfolk, NE 68701-4461
Phone (402) 644-7550

16909 Lakeside Hills CT
Omaha, NE 68130-4661

6901 N 72ND St
Suite 2244
Omaha, NE 68122-1709
Phone 40257235353575

800 Mercy Dr
Suite 10
Council Bluffs, IA 51503-3128
Phone (712) 388-2810

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Hematology & Oncology CurrentSince Aug 11, 2014 Accepting new patients
Hematology & Oncology Consultants PC CurrentSince Sep 14, 1999 Accepting new patients
Alegent Creighton Clinic CurrentSince Aug 11, 2014 Accepting new patients
Hematology & Oncology Consultants, PC Hematology & Oncology CurrentSince Sep 14, 1999 Accepting new patients
Hematology & Oncology Consultants, PC Hematology & Oncology Past Accepting new patients
Alegent Creighton Clinic Hematology & Oncology Past Accepting new patients

Locations

800 Mercy Dr
Ste 10
Council Bluffs, IA 51503
Phone (712) 388-2810

100 Medical Pkwy
Denison, IA 51442
Phone (712) 265-2500

100 Medical Pkwy
Ste A
Denison, IA 51442
Phone (712) 263-5021

2771 Solution Ctr
Chicago, IL 60677

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

110 N 29th St
Ste 1
Norfolk, NE 68701
Phone (402) 371-0925

6901 N 72nd St
Ste 2244
Omaha, NE 68122
Phone (402) 572-3535

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

Interoperability endpoints

  • Direct secure messaging: inaganti.shah@hoc.ikm.direct-ci.com

Organizations & group practices 6

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 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1295829042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641850",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647850",
            "telephone_number": "402-572-3535",
            "fax_number": "402-572-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 N 72ND ST",
            "address_2": "SUITE 2244",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681221709",
            "telephone_number": "402-572-3535",
            "fax_number": "402-572-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "INAGANTI",
        "middle_name": "MASTAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NE",
            "license": "21140",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IA",
            "license": "33127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0538751",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47077065413",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NORFOLK",
            "identifier": "830005301",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00325300",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830007286",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.