Individual provider Active NPI

Sagar Shah, MD

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1720641186
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
65969 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-6343
NPI assigned
Apr 20, 2019
Last updated
Jul 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 65969 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

4900 N 44TH St Apt 2072
Phoenix, AZ 85018-2872
Phone (708) 663-2164

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
I20240913003769 TX Practitioner - Pediatric Medicine 5698009033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Oakland Univ, William Beaumont School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (844) 424-4537

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65969AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 3, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Sep 3, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Children's Health System of Texas Past Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

1935 Medical District Dr
Unit A
Dallas, TX 75235

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658620800000",
    "number": "1720641186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 N 44TH ST APT 2072",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182872",
            "telephone_number": "708-663-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAGAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-20",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "65969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.