Active NPI
Pratik Bharat Shah, MD
- Nephrology Physician
- Mather, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- A164944
- Practice address
- 10535 Hospital Way
Mather, CA 95655-4200 - Phone
- (916) 843-2743
- NPI assigned
- Jun 3, 2010
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036.143009 | IL | |
| Internal Medicine Physician | 207R00000X | A164944 | CA | |
| Nephrology Physician | 207RN0300X | 036.143009 | IL | |
| Nephrology Physician | 207RN0300X | A164944 | CA | Primary |
Addresses
Primary practice location
10535 Hospital Way
Mather, CA 95655-4200
Mailing address
326 I St
Davis, CA 95616-4215
Phone (201) 650-6377
Other practice location 1
5841 S Maryland Ave # Mc5100
Chicago, IL 60637-1447
Phone (773) 702-1041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A164944 | CA | MD | Internal Medicine Physician |
| 036.143009 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the Univ of Ca | Current | Accepting new patients | |
| Regents of the University of Ca | Internal Medicine | Current | Accepting new patients |
| Regents of the Univ of Ca | Current | Accepting new patients | |
| Regents of the Univ of Ca | Past | Accepting new patients | |
| Regents of the Univ of Ca | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| The University of Chicago Medical Centers | Past | Accepting new patients |
Locations
4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700
4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313
2221 Stockton Blvd
Ste B
Sacramento, CA 95817
Phone (916) 734-2111
Organizations & group practices 7
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.
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-
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- NPI 1710970736
Internal Medicine
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- NPI 1427041698
-
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- NPI 1437142692
-
- General Acute Care Hospital
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- NPI 1982733655
-
- Children's Hospital
- Chicago, IL
- NPI 1093894990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579737600000",
"number": "1386964096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 I ST",
"city": "DAVIS",
"state": "CA",
"postal_code": "956164215",
"telephone_number": "201-650-6377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-843-2743"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave # Mc5100",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371447",
"country_code": "US",
"telephone_number": "773-702-1041",
"fax_number": "773-702-5818",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAH",
"first_name": "PRATIK",
"middle_name": "BHARAT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-03",
"last_updated": "2020-01-23",
"certification_date": "2020-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.143009",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A164944",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IL",
"license": "036.143009",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "A164944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mather, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.