Surendra J Shah (NPI# 1528088689, PAC ID# 5890884928) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1528088689 |
| PAC ID by PECOS | 5890884928 |
| Professional Enrollment ID | I20071127000765 |
| Full Name | Surendra J Shah |
| Organization Legal Name | SURENDRA J SHAH PC |
| Address |
5825 Broadway A Merrillville IN 46410-2664 |
| Phone Number | 2198841400 |
| Gender | M |
| Graduation Year | 1976 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | GERIATRIC MEDICINE |
| Group Practice PAC ID | 5799874822 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150002 | METHODIST HOSPITALS INC |
| 150034 | ST MARY MEDICAL CENTER INC |
| 150125 | COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5825 Broadway A, Merrillville, IN 46410-2664 | 2198841400 | SURENDRA J SHAH PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | SURENDRA J SHAH PC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pratima M Mehta | Family Medicine | Surendra J Shah PC | 5825 Broadway A, Merrillville, IN 46410-2664 |
| Street Address |
5825 BROADWAY A |
| City | MERRILLVILLE |
| State | IN |
| Zip | 46410-2664 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pratima M Mehta | Family Medicine | Surendra J Shah PC | 5825 Broadway A, Merrillville, IN 46410-2664 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dennis L Streeter | General Surgery | 8127 Merrillville Rd, Suite 3, Merrillville, IN 46410-1485 | |
| Chiedu J Nchekwube | Family Medicine | Family Medicine and Wellness Center, P.C. | 5495 Broadway, Merrillville, IN 46410-1647 |
| Juanita N Golden-allen | Nurse Practitioner | Family Medicine and Wellness Center, P.C. | 5495 Broadway, Merrillville, IN 46410-1647 |
| Jennifer Dochee | Interventional Cardiology | The Methodist Hospitals Inc | 5800 Broadway, Merrillville, IN 46410-2601 |
| Laura Rodriguez | Certified Clinical Nurse Specialist (cns) | The Methodist Hospitals Inc | 5800 Broadway, Merrillville, IN 46410-2601 |
| Mary Lorraine Hutchison | Nurse Practitioner | The Methodist Hospitals Inc | 5800 Broadway, Merrillville, IN 46410-2601 |
| Matthew J Tipton | Obstetrics/gynecology | Northshore Health Centers Inc | 6091 Broadway, Merrillville, IN 46410-2619 |
| Judith A Heilman | Nurse Practitioner | Northwest Indiana Nephrology PC | 6061 Broadway, Merrillville, IN 46410-2619 |
| Gaurav Alreja | Nephrology | Northwest Indiana Nephrology PC | 6061 Broadway, Merrillville, IN 46410-2619 |
| Harsh L Dalal | Gastroenterology | Franciscan Physician Network | 5825 Broadway, Suite B, Merrillville, IN 46410-2664 |
| Find all physicians in zip 46410 | |||
| City | MERRILLVILLE |
| Zip Code | 46410 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | MERRILLVILLE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Surendra J Shah.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.