Individual provider Active NPI

Rohit Shah, M.D.

  • Psychiatry Physician
  • Indianapolis, IN
National Provider Identifier
1376924399
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036144647 Issued in IL
Practice address
355 W 16TH St Ste 2800
Indianapolis, IN 46202-2279
Phone
(317) 963-7310
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 01082131A IN
Psychiatry Physician 2084P0800X 036144647 IL Primary

Addresses

Primary practice location

355 W 16TH St Ste 2800
Indianapolis, IN 46202-2279

Mailing address

1786 Moon Lake Blvd Ste 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

Other practice location 1

1786 Moon Lake Blvd Ste 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200316002423 IL Practitioner - Psychiatry 9335452010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alexian Brothers Behavioral Health HospitalGroup PAC ID 9537062138, 55 clinicians

Practice addresses (Care Compare)

1650 Moon Lake Blvd
Hoffman Estates, IL 60169-1010
Phone (847) 755-8090

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036144647ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Behavioral Health Hospital Psychiatry CurrentSince Apr 1, 2020 Accepting new patients

Locations

1650 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (800) 432-5005

1786 Moon Lake Blvd
Ste 104
Hoffman Estates, IL 60169

Interoperability endpoints

  • Direct secure messaging: rohit.shah.1@15182.direct.athenahealth.com

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1376924399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD STE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691016",
            "telephone_number": "847-755-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST STE 2800",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022279",
            "telephone_number": "317-963-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1786 Moon Lake Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601691016",
            "country_code": "US",
            "telephone_number": "847-755-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ROHIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "IN",
            "license": "01082131A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036144647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.