Individual provider Active NPI

Rajul P. Shah, P.A.

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1922187087
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003368 Issued in MD
Practice address
9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409
Phone
(410) 933-5678
Fax
(410) 933-1823
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003368 MD Primary

Addresses

Primary practice location

9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409

Mailing address

9601 Pulaski Park Dr
Suite 416
Baltimore, MD 21220-1409
Phone (410) 933-5678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003368MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ms-HC LLC CurrentSince Apr 2, 2010 Accepting new patients

Locations

6660 Belair Rd
Baltimore, MD 21206
Phone (410) 444-2000

9601 Pulaski Park Dr
Ste 416
Middle River, MD 21220

Organizations & group practices 1

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1922187087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678",
            "fax_number": "410-933-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 416",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678",
            "fax_number": "410-933-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAJUL",
        "middle_name": "P.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.