Kaushal J Shah, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD427835 Issued in PA

Practice address

145 Hospital Ave Ste 300
Du Bois, PA 15801-1465

Phone

(814) 375-2040

NPI assigned

Oct 13, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Wellspan Medical Group

  dba WellSpan Digestive Health

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment NPD
• Center for Podiatry Care

  dba Aiyan Diabetes Center

  • Podiatrist
  • Martinez, GA
  • NPI 1174695357

  Vascular Surgery

  Medicare reassignment NPD
• Wellspan Medical Group

  dba WellSpan Pediatric Surgical Specialist

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• Wellspan Medical Group

  dba Wellspan Pediatric Hospitalists

  • Pediatrics Physician
  • York, PA
  • NPI 1124104245
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720178536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-2040",
            "fax_number": "814-375-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE STE 300",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011465",
            "telephone_number": "814-375-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6707 Powers Blvd",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Parma",
            "state": "OH",
            "postal_code": "441295455",
            "country_code": "US",
            "telephone_number": "440-743-2380",
            "fax_number": "440-743-2381",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2006 Health Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Rockingham",
            "state": "VA",
            "postal_code": "228018679",
            "country_code": "US",
            "telephone_number": "540-689-5800",
            "fax_number": "757-431-7136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAUSHAL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101262871",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35.090188",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD427835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2650180",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720178536",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anita Shade, LSW
• Johnny Lee Shaffer
• Kaitlyn Rae Shaffer, PA-C
• Kayla Marie Shaffer, COTA
• Ghazanfar A Shah, MD
• Vihan Shah, DO
• Waqar A Shah, MD
• Satyam Sharma, DO
• Christopher Thomas Shaw, O.D.
• Marilyn Jean Sheley, RN

• Vascular Surgery Physician in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.