Pradip Shah, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-055221 Issued in IL

Practice address

200 E Fairman Ave
Watseka, IL 60970-1644

Phone

(630) 321-8300

Fax

(630) 321-8750

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: pradip.shah.1@15486.direct.athenahealth.com

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.

• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Yorkville, IL
  • NPI 1407379423
  Medicare reassignment NPD
• Iroquois Memorial Hospital and Resident Home

  • Critical Access Hospital
  • Watseka, IL
  • NPI 1629003470
  Medicare reassignment NPD
• Statera Health Care, LLC

  • Emergency Medicine Physician
  • Harrisburg, IL
  • NPI 1043874449
  Medicare reassignment NPD
• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Aurora, IL
  • NPI 1508389628
  NPD
• Acute Care Specialists II, LTD

  • Emergency Medicine Physician
  • Glendale Heights, IL
  • NPI 1205974433
  NPD (past)
• Greater Elgin Emergency Specialists LTD

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1134152366
  NPD (past)
• Hoopeston Emergency Medicine Specialists, LTD.

  • Emergency Medicine Physician
  • Hoopeston, IL
  • NPI 1316965197
  NPD (past)
• Midway Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1447397526
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1891789244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 QUAIL RIDGE DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605596142",
            "telephone_number": "630-321-8300",
            "fax_number": "630-321-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "630-321-8300",
            "fax_number": "630-321-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRADIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-055221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-055221",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pradip.shah.1@15486.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 E Fairman Ave",
            "city": "Watseka",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609701644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shakeel Sher Khan Sandozi, MD
• Samantha Sayre, MSW
• Emily Schamber
• Janella Schroeder, FNP-C
• Brittani Ann Seagren, APRN-NP, FNP-C
• Suzanne Sherrill, RN
• Therese Anne Shimon, LPC
• Allison Shindelar, MSW
• Laree A Shule, FNP-BC
• Arielle Smith

• Emergency Medicine Physician in Watseka, IL
• Providers in Watseka, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.

Verify at the official NPI Registry.