Individual provider Active NPI

Khushali Dipak Shah, O.D.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1356773337
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1932 Issued in AZ
Practice address
1703 W Bethany Home Rd
Suite C3
Phoenix, AZ 85015-2566
Phone
(602) 944-2444
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1932 AZ Primary

Addresses

Primary practice location

1703 W Bethany Home Rd
Suite C3
Phoenix, AZ 85015-2566

Mailing address

4925 E Desert Cove Ave
#323
Scottsdale, AZ 85254-5396
Phone (714) 350-5495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1932AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
America'S Best Contacts & Eyeglasses Past 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": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1356773337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 E DESERT COVE AVE",
            "address_2": "#323",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545396",
            "telephone_number": "714-350-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 W BETHANY HOME RD",
            "address_2": "SUITE C3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152566",
            "telephone_number": "602-944-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KHUSHALI",
        "middle_name": "DIPAK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.