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HARENDRA P. SHAH PA-C
NPI 1306847207
Physician Assistant - Medical in Chicago, IL

Active since August 02, 2005PECOS Enrolled
6349, N FAIRFIELD AVENUE, PRISM MEDICAL CENTER, CHICAGO, IL 60659(773) 262-1300(773) 262-1184 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Harendra P. Shah Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HARENDRA P. SHAH PA-C (NPI 1306847207) is an individual medical provider in Chicago, Illinois, licensed in Illinois (085-001700) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306847207
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameHARENDRA P. SHAHCredential: PA-C
Location Address6349, N FAIRFIELD AVENUE, PRISM MEDICAL CENTERChicago, IL 60659-1705
Mailing Address6349, N Fairfield Avenue, Prism Medical CenterChicago, IL 60659-1705 · (773) 262-1300 · Fax (773) 262-1184
Phone(773) 262-1300
Fax(773) 262-1184
Sole ProprietorNo
Enumeration DateAugust 2, 2005
Last NPPES UpdateOctober 25, 2024
NPPES CertifiedOctober 22, 2024
✔ NPI 1306847207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085-001700
6349, N FAIRFIELD AVENUE, Chicago, IL 60659
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Harendra P. Shah Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Harendra Shah's NPI number?

The NPI number for Harendra Shah is 1306847207. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Harendra Shah located?

Harendra Shah practices at 6349, N Fairfield Avenue Prism Medical Center, Chicago, IL 60659. The listed phone number is (773) 262-1300.

What is Harendra Shah's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Harendra Shah enrolled in Medicare?

Yes. Harendra Shah is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Harendra Shah was last updated on October 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.