Active NPI
Kaiser Shah, M.D.
- Anesthesiology Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036147091
- Practice address
- 3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493 - Phone
- (616) 284-3132
- NPI assigned
- Apr 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301510705 | MI | |
| Anesthesiology Physician | 207L00000X | 036147091 | IL | Primary |
Addresses
Primary practice location
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Mailing address
1107 White Pine LN
Western Springs, IL 60558-5018
Phone (630) 802-8747
Other practice location 1
12251 S 80th Ave
Palos Heights, IL 60463-1290
Phone (708) 923-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 N Highland Ave
Aurora, IL 60506-1404
Phone (630) 264-8400
1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000
Hospital & facility affiliations
- Uchicago Medicine Adventhealth Hinsdale
- Uchicago Medicine Adventhealth la Grange
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036147091 | IL | MD | Anesthesiology Physician |
| 4301510705 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Illinois, LLC | Anesthesiology | Current | Accepting new patients |
| Anesthesia Associates, LTD | Current | Accepting new patients |
Locations
1221 N Highland Ave
Aurora, IL 60506
Phone (630) 859-6700
1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521
20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857
100 5th St
Oswego, IL 60543
Phone (630) 449-0085
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
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.
-
- Pain Medicine (Anesthesiology) Physician
- Aurora, IL
- NPI 1952308223
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hinsdale, IL
- NPI 1265465439
-
- General Acute Care Hospital
- La Grange, IL
- NPI 1407889652
-
- Psychiatric Hospital Unit
- Hinsdale, IL
- NPI 1447270780
-
- Rehabilitation Hospital Unit
- La Grange, IL
- NPI 1588068274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1710305131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 WHITE PINE LN",
"city": "WESTERN SPRINGS",
"state": "IL",
"postal_code": "605585018",
"telephone_number": "630-802-8747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259493",
"telephone_number": "616-284-3132"
}
],
"practiceLocations": [
{
"address_1": "12251 S 80th Ave",
"address_purpose": "LOCATION",
"city": "Palos Heights",
"state": "IL",
"postal_code": "604631290",
"country_code": "US",
"telephone_number": "708-923-4000",
"fax_number": "708-923-8848",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAH",
"first_name": "KAISER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-02",
"last_updated": "2024-04-22",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301510705",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036147091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.