NPIMap

Individual provider Active NPI

Kevin J Shah, MD

  • Cornea and External Diseases Specialist Physician
  • Wyomissing, PA
National Provider Identifier
1740417252
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cornea and External Diseases Specialist PhysicianTaxonomy code 207WX0120X
License
MD457586 Issued in PA
Practice address
1 Granite Point Dr Ste 100
Wyomissing, PA 19610-1992
Phone
(610) 378-1344
Fax
(610) 378-5169
NPI assigned
Jun 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD457586 PA
Cornea and External Diseases Specialist Physician 207WX0120X MD457586 PA Primary

Addresses

Primary practice location

1 Granite Point Dr Ste 100
Wyomissing, PA 19610-1992

Mailing address

1 Granite Point Dr Ste 100
Wyomissing, PA 19610-1992
Phone (610) 378-1344

Other practice location 1

770 Norman Dr
Lebanon, PA 17042-7495
Phone (717) 272-2161

Other practice location 2

1494 Route 61 Hwy S Ste 100
Pottsville, PA 17901-8404
Phone (570) 621-5690

Other identifiers 3

IdentifierTypeStateIssuer
1031164500003MedicaidPA
1031164500004MedicaidPA
1031164500001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629000850 PA Practitioner - Ophthalmology 9830338045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of Ny Upstate Medical University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Consultants of Pennsylvania PCGroup PAC ID 9537142088, 25 clinicians

Practice addresses (Care Compare)

1 Granite Point Dr
Suite 100
Wyomissing, PA 19610-1992
Phone (610) 378-1344

Hospital & facility affiliations

  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

Merit-based Incentive Payment System (MIPS)

Final score
86.41 of 100Reported as group
Quality
91.46
Promoting interoperability
90
Improvement activities
40
Cost
71.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD457586PAMDCornea and External Diseases Specialist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Consultants of Pennsylvania, PC Ophthalmology CurrentSince Oct 4, 2020 Accepting new patients
Eye Consultants of Pennsylvania, PC Ophthalmology CurrentSince Aug 1, 2016 Accepting new patients
Eye Consultants of Pennsylvania, PC Ophthalmology PastSince Jun 25, 2023 Accepting new patients

Locations

219 E Wesner Rd
Blandon, PA 19510
Phone (610) 926-4241

770 Norman Dr
Lebanon, PA 17042
Phone (717) 272-2161

293 Armand Hammer Blvd
Pottstown, PA 19464
Phone (610) 327-8528

1494 Route 61 Hwy S
Ste 100
Pottsville, PA 17901
Phone (570) 621-5690

1 Granite Point Dr
Ste 100
Wyomissing, PA 19610
Phone (610) 378-1344

1 Granite Point Dr
Ste 200
Wyomissing, PA 19610
Phone (610) 685-9204

Interoperability endpoints

  • Direct secure messaging: kevin.shahmd.p1@direct.ecop.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 9

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": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1740417252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR STE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101992",
            "telephone_number": "610-378-1344",
            "fax_number": "610-378-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANITE POINT DR STE 100",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101992",
            "telephone_number": "610-378-1344",
            "fax_number": "610-378-5169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 Norman Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427495",
            "country_code": "US",
            "telephone_number": "717-272-2161",
            "fax_number": "717-270-0301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1494 Route 61 Hwy S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179018404",
            "country_code": "US",
            "telephone_number": "570-621-5690",
            "fax_number": "570-622-9285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD457586",
            "primary": false
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "PA",
            "license": "MD457586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031164500003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031164500004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031164500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.