Individual provider Active NPI

Kunal K. Shah, M.D.

  • Emergency Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1356678395
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
44554 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 546-1900
Fax
(602) 546-1918
NPI assigned
Nov 12, 2009
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 44554 AZ Primary
Pediatrics Physician 208000000X R70954 AZ
Pediatrics Physician 208000000X 44554 AZ

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

1919 E Thomas Rd
BLDG 2108, Ste 101
Phoenix, AZ 85016-7710
Phone (602) 512-8030

Other identifiers 1

IdentifierTypeStateIssuer
823982MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130731000413 AZ Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5698916898 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R70954AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Arizona, PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
District Medical Group, Inc Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
North Valley Emergency Specialists Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Cep America - Arizona PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Phoenix Children's Medical Group CurrentSince Jul 1, 2013 Accepting new patients
Progressive Medical Associates PLLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
District Medical Group, Inc CurrentSince Dec 1, 2020 Accepting new patients
Cep America- Arizona, PC Emergency Medicine Current Accepting new patients
Phoenix Children's Hospital Pediatrics Current Accepting new patients
Phoenix Children's Hospital Hope Past Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1660 S Alma School Rd
Ste 213
Mesa, AZ 85210
Phone (480) 345-3300

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1919 E Thomas Rd
Bldg 2108
Phoenix, AZ 85016
Phone (602) 512-8030

2108 E Thomas Rd
Ste 101
Phoenix, AZ 85016

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1356678395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG 2108, STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-512-8030",
            "fax_number": "602-512-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-546-1900",
            "fax_number": "602-546-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KUNAL",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "44554",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R70954",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "44554",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823982",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.