Puja Shah, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010366 Issued in IL

Practice address

3220 W Armitage Ave
Chicago, IL 60647-3797

Phone

(773) 661-6615

Fax

(773) 698-7408

NPI assigned

Jul 28, 2010

Last updated

Aug 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

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.

• Grand Central Optical Co Inc

  • Optometrist
  • New York, NY
  • NPI 1649221268
  Medicare reassignment NPD
• Krystal Klear Optical Inc.

  dba Grand Central optical

  • Optometrist
  • New York, NY
  • NPI 1861529687
  Medicare reassignment NPD
• Puja Shah O.D, P.C

  • Optometrist
  • Chicago, IL
  • NPI 1538417498
  Authorized official Same address or phone
• Galaxy Optical, Inc.

  • Eyewear Supplier
  • Hazel Crest, IL
  • NPI 1720116379
  NPD (past)
• Epic Medical Group,Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Sherman Oaks, CA
  • NPI 1295178689
  NPD (past)

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1558675942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 W ARMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473797",
            "telephone_number": "773-661-6615",
            "fax_number": "773-698-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 W ARMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473797",
            "telephone_number": "773-661-6615",
            "fax_number": "773-698-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PUJA",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010366",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prajesh Shah
• Pratik P Shah, MD
• Prerak Rajeshkumar Shah, MD
• Priti Shah, FNP-C
• Priya Shah
• Radha Shah, DO
• Rahi Rajendra Shah, DO
• Raj C Shah, M.D.
• Ranchhodlal S. Shah, M.D.
• Raveena Shah, DDS

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.