Individual provider Active NPI

Yashesh Ilesh Shah, M.D.

  • Diagnostic Radiology Physician
  • Ann Arbor, MI
National Provider Identifier
1558773440
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301106873 Issued in MI
Practice address
2215 Fuller Rd
Ann Arbor, MI 48105-2303
Phone
(734) 222-8991
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 4301106873 MI
Diagnostic Radiology Physician 2085R0202X 4301106873 MI Primary

Addresses

Primary practice location

2215 Fuller Rd
Ann Arbor, MI 48105-2303

Mailing address

2215 Fuller Rd
Ann Arbor, MI 48105-2303
Phone (734) 222-8991

Other practice location 1

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

Other names 1

  • Yashesh Shah Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200617001083 GA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 3971827775 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 27, 2020 Accepting new patients

Locations

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

13333 Northwest Fwy
Ste 540
Houston, TX 77040
Phone (281) 962-3608

Organizations & group practices 1

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": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1558773440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-222-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-222-8991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-936-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "YASHESH",
        "middle_name": "ILESH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MI",
            "license": "4301106873",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301106873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YASHESH",
            "last_name": "SHAH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.