Keyurkumar Anilkumar Shah, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

60575 Issued in MN

Practice address

1216 Ryans Rd Ste 1
Worthington, MN 56187-1722

Phone

(507) 372-2921

NPI assigned

Jan 19, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Orthopedic Surgery

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera MarshallGroup PAC ID 5799695227, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera Marshall Regional Medical Ctr Hospital, Marshall, MN, CCN 241359

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keyurkumar.shah@avera.sdhealthlink.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Avera Granite Falls

  dba Avera Granite Falls Health Center

  • Critical Access Hospital
  • Granite Falls, MN
  • NPI 1700429610
  Medicare reassignment NPD
• Avera Tyler

  dba Avera Tyler Hospital

  • Critical Access Hospital
  • Tyler, MN
  • NPI 1801840517

  Multi-Specialty

  Medicare reassignment NPD
• Avera Granite Falls

  dba Avera Medical Group Granite Falls

  • Family Medicine Physician
  • Granite Falls, MN
  • NPI 1700429644
  Medicare reassignment
• Avera Marshall

  dba Avera Medical Group Optometry - Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  dba Avera Therapy Marshall

  • Physical Therapist
  • Marshall, MN
  • NPI 1659838290
  NPD
• Avera Tyler

  dba Avera Lake Benton Clinic

  • Rural Health Clinic/Center
  • Lake Benton, MN
  • NPI 1003869892

  Multi-Specialty

  NPD
• Avera Tyler

  dba Avera Medical Group Ivanhoe

  • Rural Health Clinic/Center
  • Ivanhoe, MN
  • NPI 1063949089

  Multi-Specialty

  NPD

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

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Care Compare affiliation

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508919804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 RYANS ROAD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "56187",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD STE 1",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871722",
            "telephone_number": "507-372-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KEYURKUMAR",
        "middle_name": "ANILKUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0059271",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101239675",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2012-0683",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "MD2012-0683",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MN",
            "license": "60575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle A Saufley, OT
• Peggy Saxton, R.D.
• Amanda Schmitz, PHARM.D.
• Jodi Lynn Scott, M.D.
• Kristine Ranae Shaffer, ARNP
• Syed Asad Ali Shah, M.D.
• Meegan Shebeck, PT
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 058)
• Shopko Stores Operating Co. LLC (ShopKo Optical 058)
• Stacy Wahl Slettum, FNP

• Surgery Physician in Worthington, MN
• Providers in Worthington, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.