Harendra P. Shah, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085-001700 Issued in IL

Practice address

6349, N Fairfield Avenue
Prism Medical Center
Chicago, IL 60659-1705

Phone

(773) 262-1300

Fax

(773) 262-1184

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

No

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Niranjana Shah, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1316910250
  Medicare reassignment

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1306847207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6349, N FAIRFIELD AVENUE",
            "address_2": "PRISM MEDICAL CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591705",
            "telephone_number": "773-262-1300",
            "fax_number": "773-262-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6349, N FAIRFIELD AVENUE",
            "address_2": "PRISM MEDICAL CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591705",
            "telephone_number": "773-262-1300",
            "fax_number": "773-262-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "HARENDRA",
        "middle_name": "P.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-001700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Falguni A Shah, M.ED, LCPC
• Farwah Yawar Ali Shah, MD
• Gianne Francois Shah, LPC, NCC
• Gunjan Shah
• Hamza Shah, OD, MS
• Harita Shah
• Hassam Shah
• Hassan Shah
• Hemendra S Shah
• Hiren M Shah, MD

• Medical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.