Individual provider Active NPI

Vishal Umed Shah, MD

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1750886834
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101272101 Issued in VA
Practice address
809 82ND Parkway
Gme Office
Myrtle Beach, SC 29572
Phone
(843) 692-1752
Fax
(843) 692-1904
NPI assigned
Mar 29, 2018
Last updated
Jul 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 0101272101 VA Primary

Addresses

Primary practice location

809 82ND Parkway
Gme Office
Myrtle Beach, SC 29572

Mailing address

809 82ND Parkway
Gme Office
Myrtle Beach, SC 29572
Phone (843) 692-1752

Other practice location 1

1701 N George Mason Dr
Arlington, VA 22205-3610
Phone (240) 686-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, DE3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20210802000424 VA Practitioner - Emergency Medicine 4284987314 Reassigns benefits to 1 organization
I20210803002304 DC Practitioner - Emergency Medicine 4284987314 Reassigns benefits to 1 organization
I20260615000730 DE Practitioner - Emergency Medicine 4284987314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Howard University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

640 S State St
Dover, DE 19901-3530

640 S State St
Dover, DE 19901-3599

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101272101VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Jul 1, 2021 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2021 Accepting new patients

Locations

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

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.

Hospital & facility affiliations 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1750886834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 82ND PARKWAY",
            "address_2": "GME OFFICE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-692-1752",
            "fax_number": "843-692-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PARKWAY",
            "address_2": "GME OFFICE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-692-1752",
            "fax_number": "843-692-1904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N George Mason Dr",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222053610",
            "country_code": "US",
            "telephone_number": "240-686-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "VISHAL",
        "middle_name": "UMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101272101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.