Individual provider Active NPI

Jagdish R Shah, MD

  • Diagnostic Radiology Physician
  • Fall River, MA
National Provider Identifier
1649219312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
034903 Issued in MA
Practice address
363 Highland Ave
Radiology Department
Fall River, MA 02720-3703
Phone
(508) 677-9729
Fax
(508) 679-4728
NPI assigned
Jun 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 034903 MA Primary

Addresses

Primary practice location

363 Highland Ave
Radiology Department
Fall River, MA 02720-3703

Mailing address

484 Highland Ave
Radiology Department
Fall River, MA 02720-3704
Phone (508) 677-9729

Other identifiers 2

IdentifierTypeStateIssuer
2034719MedicaidMA
JS04208MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034903MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Reading Services LLC Diagnostic Radiology Past Accepting new patients
Coastal Imaging Associates, Inc. Diagnostic Radiology Past Accepting new patients
Aria Professional Group LLC Diagnostic Radiology Past Accepting new patients

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649219312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 HIGHLAND AVE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203704",
            "telephone_number": "508-677-9729",
            "fax_number": "508-679-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203703",
            "telephone_number": "508-677-9729",
            "fax_number": "508-679-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAGDISH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "034903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034719",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JS04208",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.