Individual provider Active NPI

Rikin R Shah, M.D.

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1699036939
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D83433 Issued in MD
Practice address
4940 Eastern Ave FL 1
Baltimore, MD 21224-2735
Phone
(410) 550-0214
Fax
(410) 550-1264
NPI assigned
Jun 4, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT201657 PA
Diagnostic Radiology Physician 2085R0202X D83433 MD Primary

Addresses

Primary practice location

4940 Eastern Ave FL 1
Baltimore, MD 21224-2735

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 933-6423

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190416003063 CA Practitioner - Interventional Radiology 2163720111 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT201657PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 11, 2018 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince May 15, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince May 15, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 11, 2018 Accepting new patients
Johns Hopkins University Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology PastSince Jun 1, 2019 Accepting new patients

Locations

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 7

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699036939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-6423",
            "fax_number": "410-933-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0214",
            "fax_number": "410-550-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RIKIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT201657",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D83433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.