Bhupendra K Shah, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

01030038A Issued in IN

Practice address

2452 Lake Ave
Fort Wayne, IN 46805-5406

Phone

(260) 422-9494

Fax

(260) 422-9142

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

Practice roles

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.

• St Joseph Medical Group Inc

  • Family Medicine Physician
  • Angola, IN
  • NPI 1801851902
  NPD (past)
• St Joseph Medical Group Inc

  • General Practice Physician
  • Fort Wayne, IN
  • NPI 1811952070
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246147200000",
    "number": "1760480800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12409",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468632409",
            "telephone_number": "260-422-9494",
            "fax_number": "260-422-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-422-9494",
            "fax_number": "260-422-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BHUPENDRA",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2009-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01030038A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079820A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney J. Shafer, NP
• Jennifer Shaffer
• Julie N. Shaffer, NP
• Noel Shafi, MS
• Shah Home Care LLC
• Priyamvada N Shah, MD
• Rishabh Shah, MD
• Sailendra Kumar Shah
• Sargam Shah, RPT
• Swapnil Shah

• Neurology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.