Individual provider Active NPI

Sonal Shah, M.D.

  • Hospitalist Physician
  • Carbondale, IL
National Provider Identifier
1598170458
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036141364 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
Fax
(618) 529-0479
NPI assigned
Jun 30, 2014
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036141364 IL
Hospitalist Physician 208M00000X 036141364 IL Primary

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156 ext. 55321

Other practice location 2

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171 ext. 35760

Other identifiers 1

IdentifierTypeStateIssuer
214881OtherILMULTISPECIALTY GROUP PTAN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sshah15803@sih.direct-ci.com
Direct Messaging Address sshah15803@sih.direct-ci.com
Direct Messaging Address sshah15803@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20161206002574 IL Practitioner - HospitalistPractitioner - Family Practice 2062637838 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Southern Illinois University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3331 W Deyoung St
Marion, IL 62959-5896
Phone (618) 998-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036141364ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. Hospitalist CurrentSince Aug 11, 2023 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Family Medicine CurrentSince Aug 11, 2023 Accepting new patients

Locations

405 W Jackson St
Carbondale, IL 62901

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

3331 W Deyoung St
Marion, IL 62959
Phone (618) 985-9140

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

Interoperability endpoints

  • Direct secure messaging: sshah01@yourcarecommunity.org
  • Direct secure messaging: sshah15803@sih.direct-ci.com

Organizations & group practices 5

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 6

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1598170458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156 x55321",
            "fax_number": "618-684-1040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171 x35760",
            "fax_number": "618-988-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SONAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036141364",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036141364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTISPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah15803@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah15803@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah15803@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.