Individual provider Active NPI

Pooja Viral Shah

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1588930739
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NPPA041036 Issued in PA
Practice address
2311 Cottman Ave
Philadelphia, PA 19149-1007
Phone
(215) 444-7505
Fax
(215) 695-2919
NPI assigned
Mar 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NPPA033948 PA
Family Nurse Practitioner 363LF0000X NPPA041036 PA Primary

Addresses

Primary practice location

2311 Cottman Ave
Philadelphia, PA 19149-1007

Mailing address

PO Box 746722
Atlanta, GA 30374-6722
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180622000236 PA Practitioner - Nurse Practitioner 7416190533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh - PA Physicians Group, PCGroup PAC ID 7517213879, 113 clinicians

Practice addresses (Care Compare)

2301 Cottman Ave
Suite 71
Philadelphia, PA 19149-1001
Phone (215) 444-7505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPPA033948PAMDFamily Nurse Practitioner
NPPA041036PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osh - PA Physicians Group, PC Family CurrentSince Jan 21, 2020 Accepting new patients
Livengrin Foundation, Inc. PastSince Oct 24, 2021 Accepting new patients

Locations

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

3621 Aramingo Ave
Philadelphia, PA 19134
Phone (312) 600-8484

2311 Cottman Ave
Ste 71
Philadelphia, PA 19149
Phone (215) 444-7505

2301 Cottman Ave
Ste 71
Philadelphia, PA 19149
Phone (215) 444-7505

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1588930739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746722",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746722",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491007",
            "telephone_number": "215-444-7505",
            "fax_number": "215-695-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "POOJA",
        "middle_name": "VIRAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-31",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "NPPA033948",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "NPPA041036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.