NPIMap

Individual provider Active NPI

Anand Anil Shah, M.D.

  • Family Medicine Physician
  • Munster, IN
National Provider Identifier
1699061457
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01074246A Issued in IN
Practice address
9134 Columbia Ave Ste a
Munster, IN 46321-2937
Phone
(219) 703-2424
Fax
(219) 703-6703
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.059735 IL
Family Medicine Physician 207Q00000X 01074246A IN Primary

Addresses

Primary practice location

9134 Columbia Ave Ste a
Munster, IN 46321-2937

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other practice location 1

1001 Main St Fl 2E
Dyer, IN 46311-1200
Phone (219) 703-2424

Other identifiers 1

IdentifierTypeStateIssuer
201238290MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804001533 IN Practitioner - Family Practice 6901023639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

9134 Columbia Ave
Suite a
Munster, IN 46321-2937
Phone (219) 703-2410

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.059735ILMDFamily Medicine Physician
01074246AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1001 Main St
Fl 2E
Dyer, IN 46311
Phone (219) 838-1100

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

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

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

9134 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 836-5550

Interoperability endpoints

  • Direct secure messaging: ashah59765@ssdirect.comhs.org

Organizations & group practices 2

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 6

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1699061457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9134 COLUMBIA AVE STE A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212937",
            "telephone_number": "219-703-2424",
            "fax_number": "219-703-6703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Main St Fl 2E",
            "address_purpose": "LOCATION",
            "city": "Dyer",
            "state": "IN",
            "postal_code": "463111200",
            "country_code": "US",
            "telephone_number": "219-703-2424",
            "fax_number": "219-703-6703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANAND",
        "middle_name": "ANIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.059735",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01074246A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201238290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.