Revette Shahara

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

005030 Issued in AZ

Practice address

3623 E Kristal Way
Phoenix, AZ 85050-2643

Phone

(586) 722-3401

NPI assigned

Oct 25, 2022

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

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248

  AZ, Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1578280103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 E KRISTAL WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850502643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 E KRISTAL WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850502643",
            "telephone_number": "586-722-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHARA",
        "first_name": "REVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "005030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed N Shah, MD
• Tejas Elesh Shah, MD
• Varsha Piyush Shah, M.A.
• Vrishti Shah, MS
• Farshid Shahangi, FNP
• Adeeb Shaheen, NP-C
• Nicole Marie Shaheen, BS
• Shahen Hospice Care Services Inc
• Madhia Shahid, MD
• Nabiha Shahid, MD

• Occupational Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.