Individual provider Active NPI

Rahul Deenesh Shah

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Hartford, CT
National Provider Identifier
1851779953
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
61778 Issued in CT
Practice address
282 Washington St
Hartford, CT 06106-3322
Phone
(860) 545-9200
NPI assigned
May 11, 2015
Last updated
Aug 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 61778 CT Primary

Addresses

Primary practice location

282 Washington St
Hartford, CT 06106-3322

Mailing address

333 Cedar St
Ynhh Department of Pediatrics
New Haven, CT 06510-3206
Phone (203) 688-1947

Other practice location 1

5 Perryridge Rd
Greenwich, CT 06830-4697
Phone (203) 863-3000

Other practice location 2

1 Park St
New Haven, CT 06504-8901
Phone (203) 688-4242

Other practice location 3

333 Cedar St
YNHH Department of Pediatrics
New Haven, CT 06510-3206
Phone (203) 688-1947

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rshah40570@connecticutchildrens.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615000170 CT Practitioner - Pediatric Medicine 4587973672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Rochester School of Medicine and Dentistry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

282 Washington St
Hartford, CT 06106-3322
Phone (860) 545-9000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61778CTMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2021 Accepting new patients
Yale University Current Accepting new patients
Yale University CurrentSince Jul 1, 2021 Accepting new patients
Connecticut Children's Specialty Group, Inc. Pediatric Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
Connecticut Children's Specialty Group, Inc. Pediatric Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients

Locations

599 Farmington Ave
Farmington, CT 06032
Phone (860) 284-4945

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

333 Cedar St
New Haven, CT 06510
Phone (203) 432-4771

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

1 Park St
North Haven, CT 06504
Phone (203) 785-2701

Interoperability endpoints

  • Direct secure messaging: rshah40570@connecticutchildrens.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1851779953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST",
            "address_2": "YNHH DEPARTMENT OF PEDIATRICS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "203-688-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 WASHINGTON ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063322",
            "telephone_number": "860-545-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Perryridge Rd",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068304697",
            "country_code": "US",
            "telephone_number": "203-863-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Park St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065048901",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Cedar St",
            "address_2": "YNHH Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103206",
            "country_code": "US",
            "telephone_number": "203-688-1947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAHUL",
        "middle_name": "DEENESH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CT",
            "license": "61778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshah40570@connecticutchildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.