Individual provider Active NPI

Kavisha Milesh Shah, MD

  • Pediatric Cardiology Physician
  • Minneapolis, MN
National Provider Identifier
1346506961
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
64962 Issued in MN
Practice address
2512 S 7TH St
Minneapolis, MN 55454-1404
Phone
(612) 365-6777
NPI assigned
Apr 9, 2012
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 64962 MN Primary

Addresses

Primary practice location

2512 S 7TH St
Minneapolis, MN 55454-1404

Mailing address

2512 S 7TH St
Minneapolis, MN 55454-1404

Other practice location 1

715 S 8th St
Minneapolis, MN 55404-1210
Phone (612) 873-6963

Other practice location 2

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Other practice location 3

1600 SW Archer Rd
Room HD 513
Gainesville, FL 32610-0296
Phone (352) 273-8234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191121000654 MN Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 7315177052 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Missouri, Kansas City, School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-7422

6405 France Ave S
Suite W200
Edina, MN 55435-2163
Phone (952) 848-5600

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Dec 2, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jan 1, 2025 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Dec 2, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians CurrentSince Dec 2, 2019 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
Fairview Clinics CurrentSince Dec 1, 2019 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 29, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
Fairview Express Care CurrentSince Dec 2, 2019 Accepting new patients
Fairview Health Services CurrentSince Dec 1, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Dec 29, 2019 Accepting new patients
Fairview Express Care CurrentSince Dec 2, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Dec 2, 2019 Accepting new patients

Locations

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2512 S 7th St
Minneapolis, MN 55454
Phone (612) 273-4277

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

6405 France Ave S
Ste W200
Minneapolis, MN 55435
Phone (952) 836-3700

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

Interoperability endpoints

  • Direct secure messaging: kshah476454@fairview.direct-ci.com

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1346506961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 S 7TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 S 7TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541404",
            "telephone_number": "612-365-6777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 S 8th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041210",
            "country_code": "US",
            "telephone_number": "612-873-6963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 SW Archer Rd",
            "address_2": "Room HD 513",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326100296",
            "country_code": "US",
            "telephone_number": "352-273-8234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAVISHA",
        "middle_name": "MILESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MN",
            "license": "64962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.