Ankur Shah, MD, PH.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD180084 Issued in OR

Practice address

8645 SE Sunnybrook Blvd Ste 200
Clackamas, OR 97015-6841

Phone

(503) 659-1694

Fax

(503) 659-1694

NPI assigned

Jul 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 8, 2020 through Jul 8, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ashah210179@direct.lhs.org

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.

• Oregon Pediatrics-Beaverton, LLC

  • Pediatrics Physician
  • Beaverton, OR
  • NPI 1649081258
  NPD (past) Authorized official
• Rupa K. Shah, MD, PC

  • Pediatrics Physician
  • Clackamas, OR
  • NPI 1275579906
  NPD (past)

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1548678402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8645 SE SUNNYBROOK BLVD STE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156841",
            "telephone_number": "503-659-1694",
            "fax_number": "503-659-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8645 SE SUNNYBROOK BLVD STE 200",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156841",
            "telephone_number": "503-659-1694",
            "fax_number": "503-659-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANKUR",
        "credential": "MD, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD180084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Kelli Severson, OCCUPATIONAL THERAPI
• Shai Sewell, DPT
• Jessica Dawn Sexton-Dorsett
• Jill M Shaddy
• Serena Amber-Nelle Shafer, AU.D.
• Ketki Girish Shah, PHD
• Rupa Kirit Shah, MD
• Parsa Shahinpoor, MD
• Mada Shami
• Eric Nicholas Shamo, MD

• Pediatrics Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.