Samir S Shah, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A95141 Issued in CA

Practice address

220 W. Arbor Dr. Dept 8781
San Diego, CA 92103-8781

Phone

(858) 552-7528

Fax

(858) 552-7549

NPI assigned

Dec 5, 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

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nephrology

Education

Wayne State University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical Group 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Medical Care Raven Dialysis facility, San Diego, CA, CCN 552798
• Kaiser Foundation Hospital - San Diego Hospital, San Diego, CA, CCN 050515
• Kaiser Foundation Hospital - San Marcos Hospital, San Marcos, CA, CCN 050855

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  CA

  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Care Compare group
• Southern California Permanente Medical Group

  • Clinical Medical Laboratory
  • N Hollywood, CA
  • NPI 1891873303
  Care Compare group
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Woodland Hills, CA
  • NPI 1952333478
  Care Compare group
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• North County Inpatient Medical Alliance, a Medical Group, Inc

  • Hospitalist Physician
  • Encinitas, CA
  • NPI 1932108115
  NPD (past)

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

• Bio-Medical Applications of California, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1366834285

  Dialysis facility

  Care Compare affiliation Name & address match
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1013062769

  Hospital

  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • San Marcos, CA
  • NPI 1558080861

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1437217841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W. ARBOR DR. DEPT 8781",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W. ARBOR DR. DEPT 8781",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038781",
            "telephone_number": "858-552-7528",
            "fax_number": "858-552-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAMIR",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A95141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nilesh Himat Shah, M.D.
• Nirja Shah
• Nisha Shah
• Rishita Shah, OT
• Ritesh Shah, D.D.S
• Sarita Shah, MD, PHD
• Seema D. Shah, M.D.
• Shailja Chandresh Shah, MD
• Shbeena Shah, DDS
• Shivani Pankaj Shah, PHARM.D., R.PH.

• All providers in San Diego, CA
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.