NPIMap

Individual provider Active NPI

Vijaykumar Sankalchand Shah, MD

  • Internal Medicine Physician
  • Warren, OH
National Provider Identifier
1851381016
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
74865 Issued in OH
Practice address
1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone
(330) 856-7702
Fax
(330) 856-1096
NPI assigned
Oct 27, 2005
Last updated
May 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 74865 OH Primary

Addresses

Primary practice location

1932 Niles Cortland Rd NE
Warren, OH 44484-1055

Mailing address

1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone (330) 856-7702

Other practice location 1

1455 Parkman Rd NW
Warren, OH 44485-2156
Phone (330) 394-3816

Other identifiers 1

IdentifierTypeStateIssuer
2080297MedicaidOH

Other names 1

  • Vijay Sankalchand Shah Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000082 OH Practitioner - Internal Medicine 2860524253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Youngstown, LLCGroup PAC ID 9234318270, 116 clinicians

Practice addresses (Care Compare)

1296 Tod PL NW
Warren, OH 44485-2474
Phone (330) 841-1001

1932 Niles Cortland Rd NE
Warren, OH 44484-1055
Phone (330) 480-6547

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74865OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Internal Medicine Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2023 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2023 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Current Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Dec 26, 2017 Accepting new patients
Community Skilled Nursing Centre Past Accepting new patients
CS Opco LLC Past Accepting new patients
2473 North Road NE Opco, LLC Past Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1296 Tod Pl NW
Warren, OH 44485
Phone (330) 306-5010

1455 Parkman Rd NW
Warren, OH 44485
Phone (330) 394-3816

1932 Niles Cortland Rd NE
Warren, OH 44484
Phone (330) 306-5300

1932 Niles Cortland Rd NE
Ste P
Warren, OH 44484
Phone (330) 306-0395

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Interoperability endpoints

  • Direct secure messaging: vshah35085@direct.bsmhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Skilled HealthcareWarren, OH, CCN 365412 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 31, 2024
Dec 31, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • CS Opco LLC

    dba Community Skilled Health Care

    • Skilled Nursing Facility
    • Warren, OH
    • NPI 1174334635

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 8

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 10

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1851381016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841055",
            "telephone_number": "330-856-7702",
            "fax_number": "330-856-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841055",
            "telephone_number": "330-856-7702",
            "fax_number": "330-856-1096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Parkman Rd NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444852156",
            "country_code": "US",
            "telephone_number": "330-394-3816",
            "fax_number": "330-399-7295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "VIJAYKUMAR",
        "middle_name": "SANKALCHAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "74865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2080297",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIJAY",
            "last_name": "SHAH",
            "middle_name": "SANKALCHAND",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.