Individual provider Active NPI

Kushal Akshay Shah, MD

  • Internal Medicine Physician
  • Burlington, MA
National Provider Identifier
1457736274
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
292678 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-0001
Phone
(781) 744-8000
NPI assigned
Jul 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 19007 NH
Internal Medicine Physician 207R00000X 292678 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-0001

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2503

Other practice location 1

789 Central Ave
Dover, NH 03820
Phone (603) 740-2503

Other identifiers 1

IdentifierTypeStateIssuer
3113063MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180723002872 NH Practitioner - Hospitalist 4486956471 Reassigns benefits to 1 organization
I20220811003639 MA Practitioner - HospitalistPractitioner - Internal Medicine 4486956471 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Acute Care Specialists PCGroup PAC ID 9234303082, 43 clinicians
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 306-6000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2503

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
292678MAMDInternal Medicine Physician
19007NHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Aug 1, 2018 Accepting new patients
Lahey Clinic, Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Massachusetts Acute Care Specialists PC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Physician Corporation Hospitalist CurrentSince Aug 1, 2018 Accepting new patients
Lahey Clinic Hospital, Inc. Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

Interoperability endpoints

  • Direct secure messaging: kshah88308@tuftsmedicine.direct-ci.com
  • Direct secure messaging: shah.kushal.wdh@direct.partners.masshiway.net
  • Direct secure messaging: kshah184781@direct.bilh.masshiway.net

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.

Hospital & facility affiliations 2

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": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1457736274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "789 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "03820",
            "country_code": "US",
            "telephone_number": "603-740-2503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KUSHAL",
        "middle_name": "AKSHAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NH",
            "license": "19007",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "292678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3113063",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.