Organization Active NPI

Pankaj Shah, M.D., P.a.

  • Allergy & Immunology (Internal Medicine) Physician
  • Houston, TX
National Provider Identifier
1679846307
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
H9712 Issued in TX
Legal business name
PANKAJ SHAH, M.D., P.A.
Practice address
8200 Wednesbury LN Ste 300
Houston, TX 77074-2932
Phone
(281) 342-3342
Fax
(281) 342-0833
NPI assigned
Feb 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Pankaj K Shah, M.D.NPI 1710981113
Title
President
Phone
(281) 342-3342

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0201X H9712 TX Primary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X H9713 TX

Addresses

Primary practice location

8200 Wednesbury LN Ste 300
Houston, TX 77074-2932

Mailing address

8200 Wednesbury LN Ste 300
Houston, TX 77074-2932
Phone (281) 342-3342

Other identifiers 2

IdentifierTypeStateIssuer
295046101MedicaidTX
295046102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120319000553 TX Part B Supplier - Clinic/Group Practice 7315107919 Receives reassigned benefits from 2 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22008/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1679846307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 WEDNESBURY LN STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770742932",
            "telephone_number": "281-342-3342",
            "fax_number": "281-342-0833"
        },
        {
            "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",
            "fax_number": "281-342-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANKAJ SHAH, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PANKAJ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-342-3342",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "TX",
            "license": "H9712",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "H9713",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295046101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295046102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.