Mirage Shah, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA2615 Issued in MD

Practice address

5201 Harry Hines Blvd
Opthalmology Clinic
Dallas, TX 75235-7708

Phone

(214) 590-5709

NPI assigned

Jul 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mirage.shah.p1@direct.katzeneye.nextgenshare.com
• Direct secure messaging: mshah685767@direct.umm.edu

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.

• Vickery Health Center

  • Psychologist
  • Dallas, TX
  • NPI 1831166446
  NPD (past)

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1306191978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 320",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017901",
            "telephone_number": "410-571-8733",
            "fax_number": "410-571-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "OPTHALMOLOGY CLINIC",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MIRAGE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8314-TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002675",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY BOARD",
            "identifier": "8314",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE NUMBER",
            "identifier": "OEG002675",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kejal R Shah, M.D
• Krusha Shah
• Kshiti Dinesh Shah, MD
• Lux Sandeep Shah, MD, MPH
• Mayank Shah, RPH
• Monal Bipin Shah, MD
• Nainesh Jashvant Shah, M.D.
• Nikhil K Shah, DMD
• Niki Shah
• Nilay Shah, DDS

• Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.