Individual provider Active NPI

Varsha D Shah, M.D.

  • Family Medicine Physician
  • Lewisville, TX
National Provider Identifier
1356428197
Registry record updated Mar 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G0102 Issued in TX
Practice address
1175 Diane Cir
Lewisville, TX 75067-4367
Phone
(972) 436-7424
Fax
(972) 219-0343
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G0102 TX Primary

Addresses

Primary practice location

1175 Diane Cir
Lewisville, TX 75067-4367

Mailing address

1175 Diane Cir
Lewisville, TX 75067-4367
Phone (972) 436-7424

Other identifiers 1

IdentifierTypeStateIssuer
8AJ489OtherTXBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20111111000693 TX Practitioner - Family PracticePractitioner - General Practice 0143419655

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G0102TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sreevani Kuncham, MD, PA PastSince Feb 9, 2017 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426982400000",
    "number": "1356428197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 DIANE CIR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674367",
            "telephone_number": "972-436-7424",
            "fax_number": "972-219-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 DIANE CIR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674367",
            "telephone_number": "972-436-7424",
            "fax_number": "972-219-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "VARSHA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G0102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8AJ489",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.