Ketan Shah MD Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

KETAN SHAH MD INC

Practice address

1100 W Town and Country Rd Ste 1250
Orange, CA 92868-4633

Phone

(949) 744-5441

Fax

(949) 266-1661

NPI assigned

Dec 14, 2023

Last updated

Feb 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ketan K Shah, MDNPI 1629244652

Title

President

Phone

(949) 744-5441

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ketan K Shah, M.D., M.B.A.

  • Gastroenterology Physician
  • Orange, CA
  • NPI 1629244652

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1952179350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1250",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684633",
            "telephone_number": "949-744-5441",
            "fax_number": "949-266-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1250",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684633",
            "telephone_number": "949-744-5441",
            "fax_number": "949-266-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAN SHAH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-02-02",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KETAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-744-5441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hari Balaji Keshava, MD
• Aryanoush Keshavarzi
• Natalia Carine Keshishian
• Kelly Kesler, MD
• Klem O Kesler
• Robin Ketchum, NP
• Kevin J. Triggs, M.D., Inc
• Kevin Pham, M.D., Inc
• Kevin Triggs MD
• Charles Keyler

• Gastroenterology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.