Individual provider Active NPI

Megha Shah Thakkar, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1386045045
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005751 Issued in IL
Practice address
5228 N Northwest Hwy
Chicago, IL 60630-4620
Phone
(773) 770-4707
NPI assigned
Sep 11, 2014
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51832 CA
Physician Assistant 363A00000X 085005751 IL Primary

Addresses

Primary practice location

5228 N Northwest Hwy
Chicago, IL 60630-4620

Mailing address

5228 N Northwest Hwy
Chicago, IL 60630-4620
Phone (773) 770-4707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, CA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160413001301 IL Practitioner - Physician Assistant 5395043095 Reassigns benefits to 1 organization
I20210616002193 IN Practitioner - Physician Assistant 5395043095 Reassigns benefits to 1 organization
I20220709000266 CA Practitioner - Physician Assistant 5395043095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians

Practice addresses (Care Compare)

10538 Mission Gorge Rd
Suite 100
Santee, CA 92071-3154
Phone (619) 456-0033

1740 Rosecrans St
San Diego, CA 92106-1928
Phone (619) 790-7800

5671 Balboa Ave
San Diego, CA 92111-2705
Phone (858) 800-2880

750 Otay Lakes Rd
Suite 272
Chula Vista, CA 91910-6915

760 Otay Lakes Rd
Chula Vista, CA 91910-6915
Phone (619) 821-2300

8590 Rio San Diego Dr
Suite 111
San Diego, CA 92108-5597
Phone (619) 736-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51832CAMDPhysician Assistant
085005751ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Somagen Healthcare Inc CurrentSince Jun 27, 2022 Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Somagen Healthcare Inc Past Accepting new patients

Locations

750 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 259-9462

760 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 821-2300

1740 Rosecrans St
San Diego, CA 92106
Phone (619) 790-7800

5671 Balboa Ave
San Diego, CA 92111
Phone (855) 362-9773

8260 Mira Mesa Blvd
Ste A
San Diego, CA 92126
Phone (855) 362-9773

8590 Rio San Diego Dr
Ste 111
San Diego, CA 92108
Phone (619) 736-4600

Organizations & group practices 5

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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1386045045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5228 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304620",
            "telephone_number": "773-770-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304620",
            "telephone_number": "773-770-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "MEGHA",
        "middle_name": "SHAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51832",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.