Individual provider Active NPI

Bharat C. Shah, M.D.

  • Specialist
  • Lorain, OH
National Provider Identifier
1548264179
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35-05-8483-S Issued in OH
Practice address
4804 Leavitt Rd
Suite a
Lorain, OH 44053-2139
Phone
(440) 989-2066
Fax
(440) 989-1153
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35-05-8483-S OH Primary

Addresses

Primary practice location

4804 Leavitt Rd
Suite a
Lorain, OH 44053-2139

Mailing address

4804 Leavitt Rd
Suite a
Lorain, OH 44053-2139
Phone (440) 989-2066

Other identifiers 11

IdentifierTypeStateIssuer
201446300OtherOHFEDERAL WORKERS COMPENSAT
BA-8214437OtherOHMULTIPLAN
0781186MedicaidOH
353056OtherOHWELLCARE
720000157OtherOHRR MEDICARE
MEDICAL MUTUAL OF OHOtherOHINDIVIDUAL PROVIDER NUMBE
341961205027OtherOHCARESOURCE
000000220928OtherOHANTHEM
7412481OtherOHAETNA
0722134004OtherOHCIGNA
106628OtherOHKAISER PERMANENTE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Care Center, Inc Specialist Current Accepting new patients
Lorain Surgery Center, LLC PastSince Sep 17, 2004 Accepting new patients

Locations

4804 Leavitt Rd
Ste A
Lorain, OH 44053
Phone (440) 989-2066

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1548264179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 LEAVITT RD",
            "address_2": "SUITE A",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440532139",
            "telephone_number": "440-989-2066",
            "fax_number": "440-989-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 LEAVITT RD",
            "address_2": "SUITE A",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440532139",
            "telephone_number": "440-989-2066",
            "fax_number": "440-989-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BHARAT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-05-8483-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMPENSAT",
            "identifier": "201446300",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "BA-8214437",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0781186",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "353056",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "720000157",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NUMBE",
            "identifier": "MEDICAL MUTUAL OF OH",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341961205027",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000220928",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7412481",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0722134004",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "106628",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.