Individual provider Active NPI

Anjali Rajesh Shah, M.D

  • Ophthalmology Physician
  • Ann Arbor, MI
National Provider Identifier
1710102496
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301087762 Issued in MI
Practice address
1000 Wall St
Ann Arbor, MI 48105-1912
Phone
(734) 764-4190
Fax
(734) 647-8052
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301087762 MI Primary

Addresses

Primary practice location

1000 Wall St
Ann Arbor, MI 48105-1912

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131104001719 MI Practitioner - Ophthalmology 7113119496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 764-4190

39901 Traditions Dr
Northville, MI 48168-9493
Phone (734) 764-4190

7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 764-4190

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301087762MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Aug 27, 2013 Accepting new patients
Regents of the University of Michigan Ophthalmology CurrentSince Aug 27, 2013 Accepting new patients
Regents of the University of Michigan Ophthalmology Current Accepting new patients
The Eye Center Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Eye Center LLC Ophthalmology PastSince Sep 19, 2006 Accepting new patients

Locations

3621 S State St
#700
Ann Arbor, MI 48108

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBEJBA

Organizations & group practices 6

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 1

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1710102496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALL ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051912",
            "telephone_number": "734-764-4190",
            "fax_number": "734-647-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANJALI",
        "middle_name": "RAJESH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301087762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.