Amol Jagdish Shah, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00039169 Issued in WA

Practice address

407 14TH Ave SE
Puyallup, WA 98372-3770

Phone

(253) 848-6661

Fax

(253) 770-5990

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Emergency Medicine

Education

Medical College of Pennsylvania, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mt Rainier Emergency Physicians PLLCGroup PAC ID 7810980968, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mt. Rainier Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Puyallup, WA
  • NPI 1538104476
  Medicare reassignment Care Compare group NPD
• Olympia Emergency Services, PLLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1346267796
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  dba MultiCare Good Samaritan Hospital

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1437186061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662050",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910662050",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723770",
            "telephone_number": "253-848-6661",
            "fax_number": "253-770-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AMOL",
        "middle_name": "JAGDISH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00039169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8289621",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Steven Sexton, O.D.
• Yvonne Y Seyler
• Shelia A Seymore, LMP
• Chengcheng Sha, DMD
• Cathryn Elizabeth Shaffer, MSOT
• Daniel Q Shakir
• Shaza Shamdeen, MD
• Shao, Lee & Hsu PLLC (Sunrise Dental of Puyallup)
• Share and Care House (Share & Care HOuse)
• Chandni Sharma, DO

• Emergency Medicine Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.

Verify at the official NPI Registry.