Individual provider Active NPI

Roma M Shah, APRN, CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1407353857
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209018470 Issued in IL
Practice address
251 E Huron St Ste 5-704
Chicago, IL 60611-2908
Phone
(312) 695-0061
Fax
(312) 695-9013
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 209018470 IL
Nurse Practitioner 363L00000X 209018470 IL Primary

Addresses

Primary practice location

251 E Huron St Ste 5-704
Chicago, IL 60611-2908

Mailing address

251 E Huron St Ste 5-704
Chicago, IL 60611-2908
Phone (312) 695-0061

Other practice location 1

5103 Fargo Ave
Skokie, IL 60077-3355
Phone (847) 730-9602

Other identifiers 1

IdentifierTypeStateIssuer
FO7182325OtherILAANP

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rshah235896@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190219001696 IL Practitioner - Nurse Practitioner 8921346883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

4445 W Irving Park Rd
Chicago, IL 60641-2808

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209018470ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Best Practices Inpatient Care, LTD. Multi-Specialty CurrentSince Feb 1, 2019 Accepting new patients
Best Practices Inpatient Care,LTD Multi-Specialty CurrentSince Feb 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation Multi-Specialty CurrentSince Feb 6, 2023 Accepting new patients
Northwestern Medical Faculty Foundation Multi-Specialty CurrentSince Feb 6, 2023 Accepting new patients
Central Dupage Physician Group Multi-Specialty PastSince May 7, 2023 Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

106 Barrington Commons Ct
Unit 1790
Barrington, IL 60011
Phone (847) 719-2220

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

251 E Huron St
Ste 5704
Chicago, IL 60611
Phone (312) 695-0061

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

3880 Salem Lake Dr
Ste F
Long Grove, IL 60047
Phone (847) 719-2220

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Interoperability endpoints

  • Direct secure messaging: rshah235896@direct.myadvocateaurora.org

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 and National Provider Directory roles.

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1407353857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-695-0061",
            "fax_number": "312-695-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-695-0061",
            "fax_number": "312-695-9013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5103 Fargo Ave",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600773355",
            "country_code": "US",
            "telephone_number": "847-730-9602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ROMA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209018470",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "FO7182325",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshah235896@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3880 Salem Lake Dr Ste F",
            "city": "Long Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3880 Salem Lake Dr Ste F",
            "city": "Long Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.