Physician Compare National (NPI:1801907779)

HEALTHCARE PROVIDER: HEERAL R SHAH M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1801907779
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365589835
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100817001323
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHAH
	Individual professional last name
Provider First Name	HEERAL
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RAMESH R SHAH, .M.D, P.C.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6103990890
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1515 HAZEL ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 105
	Group Practice or individual's line 2 address
City	CARTHAGE
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	648362842
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4173585966
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260137
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FREEMAN HEALTH SYSTEM-FREEMAN WEST
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y