Organization Active NPI

Jayesh S Shah MD

  • Nephrology Physician
  • Tampa, FL
National Provider Identifier
1770697187
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
JAYESH S SHAH MD
Practice address
1426 W Busch Blvd
Ste 105
Tampa, FL 33612-7602
Phone
(813) 935-0222
Fax
(813) 877-6330
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Jayesh S Shah, MDNPI 1366556771
Title
Owner / Provider
Phone
(813) 935-0222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1426 W Busch Blvd
Ste 105
Tampa, FL 33612-7602

Mailing address

1426 W Busch Blvd
Ste 105
Tampa, FL 33612-7602
Phone (813) 433-1002

Other identifiers 1

IdentifierTypeStateIssuer
390003723OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1426 W Busch Blvd
Ste 105
Tampa, FL 33612
Phone (813) 873-7479

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1770697187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 W BUSCH BLVD",
            "address_2": "STE 105",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127602",
            "telephone_number": "813-433-1002",
            "fax_number": "813-877-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 W BUSCH BLVD",
            "address_2": "STE 105",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127602",
            "telephone_number": "813-935-0222",
            "fax_number": "813-877-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYESH S SHAH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JAYESH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "813-935-0222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390003723",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.