Individual provider Active NPI

Roshan Shah, M.D.

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1609171628
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P7705 Issued in TX
Practice address
8200 Wednesbury LN Ste 300
Houston, TX 77074-2932
Phone
(281) 342-3342
NPI assigned
Jan 22, 2011
Last updated
Nov 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X P7705 TX Primary

Addresses

Primary practice location

8200 Wednesbury LN Ste 300
Houston, TX 77074-2932

Mailing address

17403 Rolling Brook CT
Sugar Land, TX 77479-3075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180828001306 IL Practitioner - Internal Medicine 0042483554 Reassigns benefits to 1 organization
I20180831001988 TX Practitioner - Internal Medicine 0042483554 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P7705TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Care, LLC CurrentSince Mar 1, 2015 Accepting new patients
Pankaj Shah, M.D., P.a. CurrentSince May 9, 2018 Accepting new patients
Southwest Sleep Lab PastSince May 9, 2018 Accepting new patients

Locations

9700 Gross Point Rd
Skokie, IL 60076
Phone (847) 674-7210

200 N Bryant Ave
Ste 10
Edmond, OK 73034

8200 Wednesbury Ln
Ste 300
Houston, TX 77074
Phone (281) 342-3342

4200 Shepherd Ln
Mesquite, TX 75180
Phone (972) 286-0335

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22008/brand/1/csg/1/fhir/r4
  • Direct secure messaging: roshan.shah.1@14883.direct.athenahealth.com
  • Direct secure messaging: roshan.shah.1@22008.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1295654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1609171628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17403 ROLLING BROOK CT",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742932",
            "telephone_number": "281-342-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ROSHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-22",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P7705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.