Individual provider Active NPI

Ajit Chunilal Shah, M.D.

  • Internal Medicine Physician
  • La Mirada, CA
National Provider Identifier
1528159233
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A73798 Issued in CA
Practice address
15651 Imperial Hwy Ste 104
La Mirada, CA 90638-1600
Phone
(562) 947-1619
Fax
(562) 947-5969
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A73798 CA Primary

Addresses

Primary practice location

15651 Imperial Hwy Ste 104
La Mirada, CA 90638-1600

Mailing address

15651 Imperial Hwy Ste 104
La Mirada, CA 90638-1600
Phone (562) 947-1619

Other identifiers 1

IdentifierTypeStateIssuer
00737980MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100119000168 CA Practitioner - Internal Medicine 2365584059 Practice locations: La Mirada, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15651 Imperial Hwy
Suite 104
La Mirada, CA 90638-1600
Phone (562) 947-1619

15651 Imperial Hwy 104
La Mirada, CA 90638-1600

Hospital & facility affiliations

  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169
  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73798CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1528159233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15651 IMPERIAL HWY STE 104",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381600",
            "telephone_number": "562-947-1619",
            "fax_number": "562-947-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15651 IMPERIAL HWY STE 104",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381600",
            "telephone_number": "562-947-1619",
            "fax_number": "562-947-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AJIT",
        "middle_name": "CHUNILAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00737980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.