Jayesh B Shah, MD

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

K1057 Issued in TX

Practice address

8811 Village Dr
Northeast Baptist Wound Healing Center
San Antonio, TX 78217-5415

Phone

(210) 297-2520

Fax

(210) 297-2539

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1962404830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780764",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782780764",
            "telephone_number": "210-289-5948",
            "fax_number": "210-408-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 VILLAGE DR",
            "address_2": "NORTHEAST BAPTIST WOUND HEALING CENTER",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175415",
            "telephone_number": "210-297-2520",
            "fax_number": "210-297-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAYESH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K1057",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "TX",
            "license": "K1057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1552127-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "00298U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dhiya V Shah, PSYD
• Esha Shah, DDS
• Furqan Shah, MD
• Jay Naresh Shah, D.O.
• Jaydeep Shantilal Shah, M.D.
• Jenny Soo-Jin Shah, MD
• Jharna Patel Shah, MD
• Keyurkumar Upendrakumar Shah, RPH
• Khyati Prakashkumar Shah
• Kinnari Shah, MD

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.