Individual provider Active NPI

Keyur Shah, MD

  • Diagnostic Radiology Physician
  • East Amherst, NY
National Provider Identifier
1366643157
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
256467 Issued in NY
Practice address
25 Cape Cod LN
East Amherst, NY 14051-1085
Phone
(202) 841-7776
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301084132 MI
Diagnostic Radiology Physician 2085R0202X 256467 NY Primary

Addresses

Primary practice location

25 Cape Cod LN
East Amherst, NY 14051-1085

Mailing address

25 Cape Cod LN
East Amherst, NY 14051-1085
Phone (202) 841-7776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101112000017 NY Practitioner - Diagnostic Radiology 3678639135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301084132MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Open MRI Inc CurrentSince Jun 24, 2014 Accepting new patients
Advanced Digestive Care P a Past Accepting new patients
Pro Rad, Inc Diagnostic Radiology Past Accepting new patients

Locations

848 N Rainbow Blvd
Las Vegas, NV 89107
Phone (702) 426-4138

48 Tunnel Rd
Ste 102
Pottsville, PA 17901
Phone (570) 622-6206

Organizations & group practices 3

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1366643157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CAPE COD LN",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511085",
            "telephone_number": "202-841-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CAPE COD LN",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511085",
            "telephone_number": "202-841-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KEYUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301084132",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "256467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.