Individual provider Active NPI

Syed Nayyar Shah, MD

  • Clinical Cardiac Electrophysiology Physician
  • Fort Worth, TX
National Provider Identifier
1720039480
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
L0931 Issued in TX
Practice address
1001 12TH Ave Ste 134
Fort Worth, TX 76104-3927
Phone
(817) 880-6620
Fax
(817) 880-6621
NPI assigned
May 15, 2006
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X L0931 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X L0931 TX Primary

Addresses

Primary practice location

1001 12TH Ave Ste 134
Fort Worth, TX 76104-3927

Mailing address

1001 12TH Ave Ste 134
Fort Worth, TX 76104-3927
Phone (817) 880-6620

Other identifiers 6

IdentifierTypeStateIssuer
86466KOtherTXBCBS
10032328OtherTXAMERIGROUP
1050387-01MedicaidTX
5919753OtherTXAETNA PROVIDER ID
1050387-02MedicaidTX
310501YT79OtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050922001102 TX Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 5092749804 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology and Electrophysiology Clinic Fort Worth PCGroup PAC ID 5890139224, 4 clinicians

Practice addresses (Care Compare)

1001 12TH Ave
Suite 134
Fort Worth, TX 76104-3927
Phone (817) 368-6480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
68.07
Promoting interoperability
99
Improvement activities
40
Cost
74.03

Merit-based Incentive Payment System (MIPS)

Final score
81.12 of 100Reported as group
Quality
59.84
Promoting interoperability
91
Improvement activities
40
Cost
72.5

Merit-based Incentive Payment System (MIPS)

Final score
11.46 of 100Reported as individual
Quality
20
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology and Electrophysiology Clinic Fort Worth PC Cardiovascular Disease CurrentSince Feb 1, 2024 Accepting new patients
Cardiac Cath Lab of Fort Worth LP CurrentSince Jun 3, 2013 Accepting new patients
Cardiac Imaging Inc CurrentSince Apr 1, 2024 Accepting new patients
Fort Worth Heart, P.a. CurrentSince Aug 1, 2016 Accepting new patients
Hood Medical Group PastSince Aug 1, 2016 Accepting new patients
Elite Orthopaedics of Irving PLLC Past Accepting new patients

Locations

1001 12th Ave
Ste 134
Ft Worth, TX 76104
Phone (817) 368-6480

1900 Mistletoe Blvd
Ste 100
Ft Worth, TX 76104
Phone 8173381300236

6949 Bryant Irvin Rd
Ft Worth, TX 76132
Phone (817) 332-1818

6949 Bryant Irvin Rd
Ste 110
Ft Worth, TX 76132
Phone (817) 332-1818

1008 NE Big Bend Trl
Ste 400
Glen Rose, TX 76043
Phone (682) 936-2544

1312 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-1855

2003 Rockview Dr
Granbury, TX 76049
Phone (817) 279-0399

Interoperability endpoints

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Texas Health Heart & Vascular HospitalArlington, TX, CCN 670071 Hospital Other (1.05%) Sep 10, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1720039480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 134",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043927",
            "telephone_number": "817-880-6620",
            "fax_number": "817-880-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 134",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043927",
            "telephone_number": "817-880-6620",
            "fax_number": "817-880-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SYED",
        "middle_name": "NAYYAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "L0931",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "L0931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86466K",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10032328",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1050387-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "5919753",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1050387-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "310501YT79",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.