Suresh Hirji Shah, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

033193 Issued in GA

Practice address

1235 Indian Trail Lilburn Rd
Norcross, GA 30093-4502

Phone

(770) 931-1333

Fax

(770) 931-3111

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal Medicine

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Magnolia Medical Clinic, PCGroup PAC ID 2365423142, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Magnolia Medical Clinic, P.C.

  • Internal Medicine Physician
  • Norcross, GA
  • NPI 1184711517

  Family Medicine

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1629097472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1553",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300960027",
            "telephone_number": "770-931-1333",
            "fax_number": "770-931-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 INDIAN TRAIL LILBURN RD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300934502",
            "telephone_number": "770-931-1333",
            "fax_number": "770-931-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SURESH",
        "middle_name": "HIRJI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "033193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00466958Q",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seva Family Caregiver LLC
• Seva Home Care LLC
• Julie B Sewell, NP-C
• Raven Symone' Sewell
• Ravi Suresh Shah, M.D.
• Nazeeh Shakir
• Shawnay Tykeia Shank, BT
• Manisha Sharma, MD
• Sherian Alecia Sharomi
• Kim Sue Shaver

• Family Medicine Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.