Active NPI
Manan Shah, M.D.
- Neurocritical Care Physician
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurocritical Care Physician
- License
- 079019
- Practice address
- 1120 15TH St
Augusta, GA 30912-1501 - Phone
- (706) 724-6100
- NPI assigned
- Nov 7, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 07909 | GA | |
| Neurology Physician | 2084N0400X | 079019 | GA | |
| Neurocritical Care Physician | 2084A2900X | 079019 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-1501
Mailing address
1499 Walton Way Ste 1400
Augusta, GA 30901-2603
Phone (706) 828-8401
Other practice location 1
4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000
Other practice location 2
7600 Beechnut St
Houston, TX 77074-4302
Phone (713) 500-6128
Other practice location 3
6411 Fannin St
Houston, TX 77030-1501
Phone (713) 500-6128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180123001359 | GA | Practitioner - Neurology | 0244599132 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Wellstar Medical Group LLC
Practice addresses (Care Compare)
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171
Hospital & facility affiliations
- Wellstar MCG Health, Affiliated With Med Col
- Piedmont Hospital, Inc
- Piedmont Augusta Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07909 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients |
Locations
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
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": "1352246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1376897645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 WALTON WAY STE 1400",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012603",
"telephone_number": "706-828-8401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309121501",
"telephone_number": "706-724-6100"
}
],
"practiceLocations": [
{
"address_1": "4502 Medical Dr",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782294402",
"country_code": "US",
"telephone_number": "210-358-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7600 Beechnut St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770744302",
"country_code": "US",
"telephone_number": "713-500-6128",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6411 Fannin St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770301501",
"country_code": "US",
"telephone_number": "713-500-6128",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAH",
"first_name": "MANAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-07",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "07909",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "GA",
"license": "079019",
"primary": false
},
{
"code": "2084A2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurocritical Care",
"state": "GA",
"license": "079019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.