Individual provider Active NPI

Yash D Shah, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Baton Rouge, LA
National Provider Identifier
1487107074
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
330836 Issued in LA
Practice address
8200 Constantin Blvd Ste 210
Baton Rouge, LA 70809-3481
Phone
(225) 765-5500
Fax
(225) 374-1614
NPI assigned
Jul 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 330836 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8200 Constantin Blvd Ste 210
Baton Rouge, LA 70809-3481

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5500

Other practice location 1

1 Brookdale Plz
Brooklyn, NY 11212-3139
Phone (718) 240-5893

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address yshah4160725@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20220525001076 LA Practitioner - NeurologyPractitioner - Pediatric Medicine 7618378266 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 1, 2022 Accepting new patients
Louisiana Department of Health - Office of Public Health CurrentSince Oct 15, 2023 Accepting new patients
Our Lady of the Lake Physician Group LLC Current Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Louisiana Department of Health - Office of Public Health CurrentSince Oct 15, 2023 Accepting new patients
Louisiana Department of Health - Office of Public Health Current Accepting new patients
Woman'S Specialty Clinic CurrentSince Feb 13, 2024 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

330 W Oak St
Amite, LA 70422
Phone (985) 748-2020

500 Rue de la Vie St
Ste 511
Baton Rouge, LA 70817
Phone (225) 752-3000

500 Rue de la Vie St
Ste 311
Baton Rouge, LA 70817
Phone (225) 216-3006

8200 Constantin Blvd
Ste 210
Baton Rouge, LA 70809
Phone (225) 374-4985

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

626 Carolina Ave
Bogalusa, LA 70427
Phone (985) 732-6615

1029 Capitol Ave
Crowley, LA 70526
Phone (337) 788-7507

15481 W Club Deluxe Rd
Hammond, LA 70403
Phone (985) 543-4165

20399 Government Blvd
Livingston, LA 70754

111 N Causeway Blvd
Metairie, LA 70001
Phone (504) 482-0084

Interoperability endpoints

  • Direct secure messaging: yshah4160725@direct.casso.us.com

Organizations & group practices 8

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": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1487107074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 CONSTANTIN BLVD STE 210",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093481",
            "telephone_number": "225-765-5500",
            "fax_number": "225-374-1614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brookdale Plz",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112123139",
            "country_code": "US",
            "telephone_number": "718-240-5893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "YASH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "LA",
            "license": "330836",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yshah4160725@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "yshah4160725@direct.casso.us.com",
            "address_1": "8200 Constantin Blvd Ste 210",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8200 Constantin Blvd Ste 210",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708093481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.