Individual provider Active NPI

Sambhav Shah, MD

  • Emergency Medicine Physician
  • Munster, IN
National Provider Identifier
1669433512
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01068910A Issued in IN
Practice address
901 Macarthur Blvd
Munster, IN 46321-2901
Phone
(219) 836-1600
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35080854S OH
Emergency Medicine Physician 207P00000X 01068910A IN Primary

Addresses

Primary practice location

901 Macarthur Blvd
Munster, IN 46321-2901

Mailing address

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965

Other practice location 1

36000 Euclid Ave
Willoughby, OH 44094
Phone (440) 953-6203

Other practice location 2

10855 Virginia St
Crown Point, IN 46307-0210
Phone (888) 824-0200

Other identifiers 1

IdentifierTypeStateIssuer
2344216MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 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
I20110302001058 IN Practitioner - Emergency Medicine 7416073655 Reassigns benefits to 2 organizations
I20110307000508 IL Practitioner - Emergency Medicine 7416073655 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians
Rush Oak Park ER Physicians GroupGroup PAC ID 8820190606, 29 clinicians

Practice addresses (Care Compare)

10855 Virginia St
Suite 1700
Crown Point, IN 46307-0210
Phone (888) 824-0200

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 563-4270

520 S Maple Ave
Oak Park, IL 60304-1022
Phone (708) 660-6665

Hospital & facility affiliations

  • Uchicago Medicine Northwest Indiana Hospital, Crown Point, IN, CCN 150195
  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119
  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01068910AINMDEmergency Medicine Physician
35080854SOHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush Oak Park ER Physicians Group CurrentSince Dec 15, 2021 Accepting new patients
Community Care Network Inc CurrentSince Feb 15, 2014 Accepting new patients
St Mary Medical Center Inc Current Accepting new patients
University of Chicago CurrentSince Sep 19, 2024 Accepting new patients
Dupage Emergency Physicians Convenient Care LLC Emergency Medicine CurrentSince Jul 10, 2020 Accepting new patients
Rush University Medical Center CurrentSince Sep 25, 2023 Accepting new patients
Rush University Medical Group Emergency Medicine CurrentSince Sep 25, 2023 Accepting new patients
Indiana Physician Services LLC Emergency Medicine Past Accepting new patients
Lake Emergency Services Inc Emergency Medicine Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

75 Remittance Dr
Dept 1620
Chicago, IL 60675

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

15900 W 127th St
Lemont, IL 60439
Phone (630) 243-7100

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

10855 Virginia St
Ste 1700
Crown Point, IN 46307

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Ste 109
Hobart, IN 46342
Phone (219) 942-0551

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

Interoperability endpoints

  • Direct secure messaging: sshah187256@direct.rush.rush-health.com

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1669433512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36000 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Willoughby",
            "state": "OH",
            "postal_code": "44094",
            "country_code": "US",
            "telephone_number": "440-953-6203",
            "fax_number": "440-953-6202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10855 Virginia St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463070210",
            "country_code": "US",
            "telephone_number": "888-824-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAMBHAV",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35080854S",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01068910A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2344216",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.