Active NPI
Niraj Shah
- Family Medicine Physician
- Mount Pleasant, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 64153
- Practice address
- 8400 Washington Ave
Mount Pleasant, WI 53406-3735 - Phone
- (262) 884-4000
- NPI assigned
- Jun 11, 2012
- Last updated
- Aug 5, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125.061309 | IL | |
| Family Medicine Physician | 207Q00000X | 64153 | WI | Primary |
Addresses
Primary practice location
8400 Washington Ave
Mount Pleasant, WI 53406-3735
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
2020 Ogden Ave
Suite 325
Aurora, IL 60504-5894
Phone (630) 978-4850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100046771 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nshah152146@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8348 Washington Ave
Mount Pleasant, WI 53406-3733
Phone (262) 884-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.061309 | IL | MD | Family Medicine Physician |
| 64153 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Copley Memorial Hospital Inc. | Family Medicine | Past | Accepting new patients |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
8348 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 884-4000
8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000
Interoperability endpoints
- nshah152146@direct.myadvocateaurora.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
-
dba Rush-Copley Family Medicine Center
- Family Medicine Physician
- Aurora, IL
- NPI 1629003165
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kenosha, WI
- NPI 1225156888
-
dba Aurora at Home
- Home Health Agency
- West Allis, WI
- NPI 1134255037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1326300831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8400 WASHINGTON AVE",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534063735",
"telephone_number": "262-884-4000"
}
],
"practiceLocations": [
{
"address_1": "2020 Ogden Ave",
"address_2": "Suite 325",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "IL",
"postal_code": "605045894",
"country_code": "US",
"telephone_number": "630-978-4850",
"fax_number": "630-978-6865",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAH",
"first_name": "NIRAJ",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-11",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125.061309",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "64153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100046771",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nshah152146@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2020 Ogden Ave",
"address_2": "Suite 325",
"city": "Aurora",
"state": "IL",
"country_code": "US",
"postal_code": "605045894",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2020 Ogden Ave",
"address_2": "Suite 325",
"city": "Aurora",
"state": "IL",
"country_code": "US",
"postal_code": "605045894",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mount Pleasant, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.