PRAKASH SHANTILAL SHAH (MD) – Internal Medicine Physician, NPI 1104043801

PRAKASH SHANTILAL SHAH (MD) is a healthcare provider. based in Sandy, Utah. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 36825 (AZ). The NPI Number for PRAKASH SHANTILAL SHAH (MD) is 1104043801

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
PRAKASH SHANTILAL SHAH (MD)
NPI
1104043801
Phone
(866) 869-2395
Address
PO BOX 708850
Enumeration Date
20 April 2007
Last Update Date
29 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5107971111
Graduation Year
1988 (38 years ago)
PAC ID
6800997206
Group Practice PAC ID
8426062027
Professional Enrollment ID
I20101220001051
Address ID
CA945381716FR2000XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,582 INTERNAL MEDICINE in AZ

Provider Addresses for PRAKASH SHANTILAL SHAH (MD)

  • PO BOX 708850

    SANDY, UT 840708850

    Phone: (866) 869-2395

    Fax: (801) 352-9502

    Type: Mailing

  • 6644 E BAYWOOD AVE

    MESA, AZ 852061747

    Phone: (408) 981-4391

    Fax: (480) 981-4624

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-12-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101220001051IInternal MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes168158$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes15468$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes13871$0
99239Hospital discharge day management, more than 30 minutes6151$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes4140$0
View full utilization report →

Insurance plans in this area (ZIP 84070)

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Provider's Procedures

PRAKASH SHANTILAL SHAH (MD) performs procedures in INTERNAL MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEAZ93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report3231

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426062027View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to PRAKASH SHANTILAL SHAH (MD)?
NPI 1104043801 is assigned to PRAKASH SHANTILAL SHAH (MD) under the national enumeration system.
Is PRAKASH SHANTILAL SHAH (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is PRAKASH SHANTILAL SHAH (MD)?
The page reflects Internal Medicine Physician for PRAKASH SHANTILAL SHAH (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for PRAKASH SHANTILAL SHAH (MD)?
The page summarizes Sandy, Utah for PRAKASH SHANTILAL SHAH (MD); expand the address list for detail.
What if Sandy, Utah seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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