Individual provider Active NPI

Subhash H Shah, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Wichita, KS
National Provider Identifier
1588667372
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
04-24004 Issued in KS
Practice address
220 S Hillside St Ste a
Wichita, KS 67211-2151
Phone
(316) 686-6866
Fax
(316) 686-9797
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 04-24004 KS
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X 04-24004 KS Primary

Addresses

Primary practice location

220 S Hillside St Ste a
Wichita, KS 67211-2151

Mailing address

220 S Hillside St Ste a
Wichita, KS 67211-2151
Phone (316) 686-6866

Other identifiers 1

IdentifierTypeStateIssuer
100136270BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20050607000603 KS Practitioner - NeurologyPractitioner - Other (Physician) 8527001932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Subhash Shah MD PAGroup PAC ID 5496022303, 2 clinicians

Practice addresses (Care Compare)

Wichita, KS 67211
Phone (316) 686-6866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-24004KSMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Subhash Shah MD PA Specialist CurrentSince Jan 1, 1998 Accepting new patients

Locations

220 S Hillside St
Ste A
Wichita, KS 67211
Phone (316) 686-6866

220 S Hillside St
Wichita, KS 67211
Phone (316) 686-6866

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1588667372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S HILLSIDE ST STE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112151",
            "telephone_number": "316-686-6866",
            "fax_number": "316-686-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S HILLSIDE ST STE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112151",
            "telephone_number": "316-686-6866",
            "fax_number": "316-686-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUBHASH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KS",
            "license": "04-24004",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KS",
            "license": "04-24004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100136270B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.