Individual provider Active NPI

Girishkumar Popatlal Shah, M.D.

  • Psychiatry Physician
  • Hammond, LA
National Provider Identifier
1538210109
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
07754R Issued in LA
Practice address
835 Pride Dr
Ste B
Hammond, LA 70401-9527
Phone
(985) 543-4333
Fax
(985) 543-4817
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 07754R LA Primary

Addresses

Primary practice location

835 Pride Dr
Ste B
Hammond, LA 70401-9527

Mailing address

23 Piper LN
Mandeville, LA 70448-3455
Phone (985) 626-1487

Other identifiers 1

IdentifierTypeStateIssuer
1914983MedicaidLA

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
I20081020000002 LA Practitioner - Psychiatry 9638237779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

835 Pride Dr
Suite B
Hammond, LA 70401-9527
Phone (985) 543-4730

900 Wilkinson St
Fphsa Mandeville Clinic
Mandeville, LA 70448-3533
Phone (985) 624-4450

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Parishes Human Services Authority CurrentSince Apr 1, 2015 Accepting new patients
Florida Parishes Human Services Authority CurrentSince Apr 1, 2015 Accepting new patients

Locations

400 Georgia Ave
Ste 1
Bogalusa, LA 70427
Phone (985) 732-6610

1951 Florida Ave SW
#D
Denham Springs, LA 70726

1951 Florida Ave SW
Ste D
Denham Springs, LA 70726
Phone (225) 665-0473

835 Pride Dr
Ste B
Hammond, LA 70401
Phone (985) 543-4333

900 Wilkinson St
Mandeville, LA 70448
Phone (985) 624-4450

2331 Carey St
Slidell, LA 70458
Phone (985) 646-6406

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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1538210109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PIPER LN",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483455",
            "telephone_number": "985-626-1487",
            "fax_number": "985-626-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 PRIDE DR",
            "address_2": "STE B",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704019527",
            "telephone_number": "985-543-4333",
            "fax_number": "985-543-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "GIRISHKUMAR",
        "middle_name": "POPATLAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "07754R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1914983",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.