Individual provider Active NPI

Kristin Brozena Shah, M.D.

  • Obstetrics & Gynecology Physician
  • San Antonio, TX
National Provider Identifier
1962661090
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
P2203 Issued in TX
Practice address
502 Madison Oak Dr
Suite 440
San Antonio, TX 78258-4084
Phone
(210) 946-1300
Fax
(210) 946-1700
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X P2203 TX Primary

Addresses

Primary practice location

502 Madison Oak Dr
Suite 440
San Antonio, TX 78258-4084

Mailing address

502 Madison Oak Dr
Suite 440
San Antonio, TX 78258-4084
Phone (210) 946-1300

Other identifiers 1

IdentifierTypeStateIssuer
303124701MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120813000389 TX Practitioner - Obstetrics/Gynecology 9739335423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women Partners in OB/GYN LLPGroup PAC ID 1557350238, 10 clinicians

Practice addresses (Care Compare)

502 Madison Oak Dr
Suite 440
San Antonio, TX 78258-4189
Phone (210) 946-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Women Partners in OB/GYN LLP Obstetrics & Gynecology CurrentSince Aug 20, 2012 Accepting new patients
VHS San Antonio Partners LLC Past Accepting new patients

Locations

502 Madison Oak Dr
Ste 440
San Antonio, TX 78258
Phone (210) 946-1300

5000 Baptist Health Dr
Ste 100
Schertz, TX 78154
Phone (210) 946-1300

5000 Baptist Health Dr
#10
Schertz, TX 78154
Phone (210) 946-1300

Organizations & group practices 2

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1962661090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MADISON OAK DR",
            "address_2": "SUITE 440",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584084",
            "telephone_number": "210-946-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MADISON OAK DR",
            "address_2": "SUITE 440",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584084",
            "telephone_number": "210-946-1300",
            "fax_number": "210-946-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KRISTIN",
        "middle_name": "BROZENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P2203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303124701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.