NPIMap

Individual provider Active NPI

Bharat J Shah, MD

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1811980717
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
R3A49 Issued in MO
Practice address
11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6132
Phone
(314) 839-5522
Fax
(314) 839-5351
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X R3A49 MO Primary
Cardiovascular Disease Physician 207RC0000X 036064312 IL

Addresses

Primary practice location

11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6132

Mailing address

11125 Dunn Rd
Suite 204
Saint Louis, MO 63136-6132
Phone (314) 839-5522

Other identifiers 13

IdentifierTypeStateIssuer
1993V3831OtherGHP/CMR
4040666OtherAETNA
1475257OtherCIGNA
103383OtherHLNK
27888OtherMOMOBS/BLCHOICE
42760V30946OtherHLTHPART
060067911OtherILILRRMCR
2509028OtherUHC
000000013077OtherESSENCE
A29082OtherMERCY
060015451OtherMOMORRMCR
10095V8816OtherHCUSA
201865219MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3A49MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis Cardiovascular Disease Past Accepting new patients
SSM St. Charles Clinic Medical Group, Inc. Past Accepting new patients
SSM Health Care St. Louis Cardiovascular Disease Past Accepting new patients
St Louis Cardiology Consultants LTD Cardiovascular Disease Past Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
Saint Anthony'S Physician Group Past Accepting new patients
SSM Health Care St. Louis Cardiovascular Disease Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1811980717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "address_2": "SUITE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-839-5522",
            "fax_number": "314-839-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "address_2": "SUITE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-839-5522",
            "fax_number": "314-839-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BHARAT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "R3A49",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036064312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP/CMR",
            "identifier": "1993V3831",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4040666",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1475257",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLNK",
            "identifier": "103383",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOBS/BLCHOICE",
            "identifier": "27888",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HLTHPART",
            "identifier": "42760V30946",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILRRMCR",
            "identifier": "060067911",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2509028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000013077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "A29082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MORRMCR",
            "identifier": "060015451",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCUSA",
            "identifier": "10095V8816",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201865219",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.