Individual provider Active NPI

Kavit B Shah, MD

  • Vascular Neurology Physician
  • Milwaukee, WI
National Provider Identifier
1730507930
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
20561 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy Ste 680
Milwaukee, WI 53215-3633
Phone
(414) 385-1922
Fax
(414) 385-1899
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036171267 IL
Vascular Neurology Physician 2084V0102X MD467191 PA
Vascular Neurology Physician 2084V0102X 20561 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 680
Milwaukee, WI 53215-3633

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 385-1922

Other practice location 1

2799 W Grand Blvd
Puh C-400
Detroit, MI 48202-2608
Phone (313) 916-2585

Other practice location 2

4440 W 95th St
Oak Lawn, IL 60453-2600
Phone (303) 436-2727

Other identifiers 1

IdentifierTypeStateIssuer
100171343MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address kavit.b.shah@upmcdirect.com UPMC
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address kshah307964@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 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

Enrollment IDStateProvider typePAC IDDetails
I20210728003792 WI Practitioner - Neurology 1456576495 Reassigns benefits to 1 organization
I20241113001306 IL Practitioner - Neurology 1456576495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Toledo College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3669
Phone (414) 385-8600

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Aurora Medical Center - Summit Hospital, Summit, WI, CCN 520206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036171267ILMDNeurology Physician
20561WIMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Nov 15, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 15, 2024 Accepting new patients
Aurora Medical Group, Inc. PastSince Aug 8, 2021 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

2801 W Kinnickinnic River Pkwy
Ste 680
Milwaukee, WI 53215
Phone (414) 385-1922

Interoperability endpoints

  • Direct secure messaging: kshah307964@direct.myadvocateaurora.org
  • Direct secure messaging: kshah282686@direct.hfhs.org

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 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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1730507930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-385-1922",
            "fax_number": "414-385-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 680",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153633",
            "telephone_number": "414-385-1922",
            "fax_number": "414-385-1899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_2": "PUH C-400",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4440 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532600",
            "country_code": "US",
            "telephone_number": "303-436-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAVIT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036171267",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "PA",
            "license": "MD467191",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "WI",
            "license": "20561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100171343",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kavit.b.shah@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 680",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshah307964@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 680",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.