Poorvi P Shah, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101027987 Issued in MI

Practice address

1961 S Telegraph Rd
Bloomfield Hills, MI 48302-0246

Phone

(248) 319-6190

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 7, 2016 through Mar 7, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25605/brand/1/csg/1/fhir/r4

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.

• Cisco Medical Group, Inc

  dba Cisco Medical Group - Reseda

  • Primary Care Clinic/Center
  • Reseda, CA
  • NPI 1053408989
  NPD (past)
• Cisco Medical Group, Inc

  dba Cisco Medical Group - Burbank

  • Primary Care Clinic/Center
  • Burbank, CA
  • NPI 1164097341
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1306918073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 S TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020246",
            "telephone_number": "248-319-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Park Ave Ste B2",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220464312",
            "country_code": "US",
            "telephone_number": "703-473-9698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "POORVI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7799",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202756",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seyfried Sleep LLC
• Sandra Lee Seyfried, DDS
• Seymour Baxter M.D., PC
• Reeta Shaffo, DDS
• Akshay B Shah, M.D.
• Priya Shah
• Reene Shallal, FNP
• Fayek Nicholas Shamma, MD
• Abul Shamsuddoha, M.D.
• Jeffrey Allan Sharbaugh, RPH

• Family Medicine Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.