Active NPI
Yatin Shah, M.D.
- Pediatrics Physician
- Dublin, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C53259
- Practice address
- 4050 Dublin Blvd
Dublin, CA 94568-3112 - Phone
- (925) 875-6100
- NPI assigned
- Jun 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C53259 | CA | Primary |
| Pediatrics Physician | 208000000X | K1668 | TX |
Addresses
Primary practice location
4050 Dublin Blvd
Dublin, CA 94568-3112
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Phone (925) 875-6100
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83Y185 | Other | TX | BCBS PROVIDER NUMBER |
| 125438503 | Medicaid | TX | |
| 1655359001 | Other | TX | CIGNA PROV NUMBER |
| 123734100 | Other | TX | FIRST CARE PROV NUMBER |
| 141962301 | Other | TX | UNITED HEALTHCARE PROV NO |
| 5004343 | Other | TX | AETNA PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53259 | CA | MD | Endodontist |
| C53259 | CA | MD | Pediatrics Physician |
| K1668 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Stanford Health Care Tri-Valley | Past | Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients |
Locations
4050 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-6100
3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977
2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200
550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865
Interoperability endpoints
- yshah236341@hisp.ehr.sutterhealth.org
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
- Clinical Medical Laboratory
- Santa Clara, CA
- NPI 1669287033
-
- General Acute Care Hospital
- Pleasanton, CA
- NPI 1144389941
-
- Family Medicine Physician
- Orinda, CA
- NPI 1871538769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1780680546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408",
"telephone_number": "925-875-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 DUBLIN BLVD",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945683112",
"telephone_number": "925-875-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "YATIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-24",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C53259",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "K1668",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "83Y185",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125438503",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROV NUMBER",
"identifier": "1655359001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CARE PROV NUMBER",
"identifier": "123734100",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PROV NO",
"identifier": "141962301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "5004343",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dublin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.