Chetan Chandulal Shah, M.B.B.S

Primary specialty

Pediatric Radiology PhysicianTaxonomy code 2085P0229X

License

ME113302 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-8426

Phone

(352) 265-0291

Fax

(352) 265-0279

NPI assigned

Jun 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR, FL2 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

Specialty

Diagnostic Radiology

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1386658615
  Medicare reassignment NPD
• Arkansas Childrens Hospital

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• Arkansas Childrens Professional Services Organization LLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1629889464
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1265585806
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Arkansas Children'S Hospital

  • Children's Hospital
  • Little Rock, AR
  • NPI 1477561983
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408

  Hospital

  Care Compare affiliation
• Shands Jacksonville Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313
  Care Compare affiliation

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1346446911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100374",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100374",
            "telephone_number": "352-265-0291",
            "fax_number": "352-265-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326108426",
            "telephone_number": "352-265-0291",
            "fax_number": "352-265-0279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078426",
            "country_code": "US",
            "telephone_number": "904-697-3694",
            "fax_number": "904-697-3927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "CHETAN",
        "middle_name": "CHANDULAL",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "AR",
            "license": "E-5677",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "DE",
            "license": "C10010212",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "AR",
            "license": "E-5677",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME113302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170947001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006569400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Shaffer
• Jeffrey Shaffren, PHARMD
• Fianna Shafirovich, DMD
• Alisha K Shah
• Ankit Anil Shah, M.D.
• Deesha Manishkumar Shah, MBBS
• Khushali Nitin Shah, M.OT
• Kreesha Shah, MD
• Kruti Shah
• Kunjan Jayantkumar Shah, PHARMD

• Pediatric Radiology Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Pediatric Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.

Verify at the official NPI Registry.