Individual provider Active NPI

Ankit Minesh Shah, PT

  • Physical Therapist
  • Ceres, CA
National Provider Identifier
1902334071
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297491 Issued in CA
Practice address
2908 E Whitmore Ave Ste E
Ceres, CA 95307-2800
Phone
(209) 622-4149
Fax
(209) 622-4159
NPI assigned
Jun 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 26429 MD
Physical Therapist 225100000X 297491 CA Primary

Addresses

Primary practice location

2908 E Whitmore Ave Ste E
Ceres, CA 95307-2800

Mailing address

2908 E Whitmore Ave Ste E
Ceres, CA 95307-2800
Phone (209) 622-4149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112000929 CA Practitioner - Physical Therapist in Private Practice 4688052590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

1906 Vista del Lago Dr
Suite a
Valley Springs, CA 95252-9700
Phone (209) 772-0848

2908 E Whitmore Ave
Suite E
Ceres, CA 95307-2800
Phone (209) 622-4149

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26429MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince May 2, 2022 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients
Active Physical Therapy Services, LLC Physical Therapist Past Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients
Maryland Spine Rehab, LLC PastSince May 2, 2022 Accepting new patients

Locations

2908 E Whitmore Ave
Ste E
Ceres, CA 95307
Phone (209) 264-8934

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

1515 Merritt Blvd
Dundalk, MD 21222
Phone (410) 285-0920

7106 Ridge Rd
Ste 150
Rosedale, MD 21237
Phone (410) 238-3030

3536A Urbana Pike
Urbana, MD 21704
Phone (301) 874-9200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1902334071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 E WHITMORE AVE STE E",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953072800",
            "telephone_number": "209-622-4149",
            "fax_number": "209-622-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 E WHITMORE AVE STE E",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953072800",
            "telephone_number": "209-622-4149",
            "fax_number": "209-622-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANKIT",
        "middle_name": "MINESH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26429",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceres, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.