Individual provider Active NPI

Khusbu D Shah, PA-C

  • Physician Assistant
  • Streamwood, IL
National Provider Identifier
1457083677
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
135 E Irving Park Rd
Streamwood, IL 60107-2950
Phone
(844) 599-3700
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 IL Primary
Physician Assistant 363A00000X PA68128 CA

Addresses

Primary practice location

135 E Irving Park Rd
Streamwood, IL 60107-2950

Mailing address

1826 Largo CT
Schaumburg, IL 60194-2227
Phone (630) 460-0029

Other practice location 1

15525 Pomerado Rd Ste A1
Poway, CA 92064-2425
Phone (858) 485-6644

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
I20230612000572 IL Order and Referring Only - Physician Assistant 0749647477

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Family Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: khusbu.shah.p1@direct.gefcc.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457083677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 LARGO CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601942227",
            "telephone_number": "630-460-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072950",
            "telephone_number": "844-599-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15525 Pomerado Rd Ste A1",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920642425",
            "country_code": "US",
            "telephone_number": "858-485-6644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KHUSBU",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA68128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.