NPIMap

Individual provider Active NPI

Rutul Shah, M.D

  • Sleep Medicine (Internal Medicine) Physician
  • Norfolk, VA
National Provider Identifier
1881899557
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
0101253419 Issued in VA
Practice address
150 Kingsley LN
Norfolk, VA 23505-4602
Phone
(757) 484-5900
Fax
(757) 483-6671
NPI assigned
Jun 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sleep Medicine (Internal Medicine) Physician 207RS0012X 0101253419 VA Primary
Pulmonary Disease Physician 207RP1001X 32541 SC

Addresses

Primary practice location

150 Kingsley LN
Norfolk, VA 23505-4602

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149

Other practice location 1

5818 Harbour View Blvd Ste B2
Suffolk, VA 23435-2785
Phone (757) 484-5900

Other identifiers 4

IdentifierTypeStateIssuer
PO1162145OtherSCRAILROAD MEDICARE
325419MedicaidSC
GP4306OtherSCMEDICAID GROUP
GP3912OtherSCMEDICAID GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130926000051 VA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Sleep Medicine 6103014501 Reassigns benefits to 3 organizations
I20190501000433 NC Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6103014501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bon Secours Medical Group Hampton Roads Specialty Care LLCGroup PAC ID 3173955671, 197 clinicians
Sound Physicians Intensivists of Virginia LLCGroup PAC ID 1759611411, 49 clinicians

Practice addresses (Care Compare)

150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

5818 Harbour View Blvd
Suffolk, VA 23435-3315

Hospital & facility affiliations

  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017
  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067
  • Bon Secours Harbour View Medical Center Hospital, Suffolk, VA, CCN 490148

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32541SCMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Medical Services, Inc. Family Medicine CurrentSince Mar 22, 2019 Accepting new patients
Sound Physicians Intensivists of Virginia LLC Pulmonary Disease CurrentSince May 10, 2024 Accepting new patients
Moses Cone Medical Services, Inc. Family Medicine CurrentSince Mar 22, 2019 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205

520 N Elam Ave
Greensboro, NC 27403
Phone (336) 475-7148

940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1881899557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KINGSLEY LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054602",
            "telephone_number": "757-484-5900",
            "fax_number": "757-483-6671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5818 Harbour View Blvd Ste B2",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234352785",
            "country_code": "US",
            "telephone_number": "757-484-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RUTUL",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "VA",
            "license": "0101253419",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "32541",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PO1162145",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325419",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "GP4306",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "GP3912",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.