Ketan A Shah (NPI# 1841306693, PAC ID# 2264574359) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1841306693 |
| PAC ID by PECOS | 2264574359 |
| Professional Enrollment ID | I20100128000148 |
| Full Name | Ketan A Shah |
| Organization Legal Name | ENT AND SLEEP MEDICINE ASSOCIATES LLC |
| Address |
1000 Eleven S Suite 4f Columbia IL 62236-1080 |
| Phone Number | 6186280715 |
| Gender | M |
| Medical School | UMDNJ-NEW JERSEY MEDICAL SCHOOL |
| Graduation Year | 1994 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 3072700483 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140137 | GREENVILLE REGIONAL HOSPITAL |
| 140125 | GATEWAY REGIONAL MEDICAL CENTER |
| 140187 | HSHS ST ELIZABETH'S HOSPITAL |
| 140185 | MEMORIAL HOSPITAL |
| 140307 | METRO-EAST SERVICES INC |
| Address | Phone | Organization |
|---|---|---|
| 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 | 6186280715 | ENT AND SLEEP MEDICINE ASSOCIATES LLC |
| Organization Legal Name | ENT AND SLEEP MEDICINE ASSOCIATES LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth A Fernandez | Qualified Audiologist | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Mark A Szewczyk | Otolaryngology | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Ryan M George | Otolaryngology | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Andrew J Nash | Qualified Audiologist | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Richard K Kleinschmidt | Physician Assistant | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Street Address |
1000 ELEVEN S SUITE 4F |
| City | COLUMBIA |
| State | IL |
| Zip | 62236-1080 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Lynette Yates | Nurse Practitioner | Red Bud Regional Clinic Company LLC | 1000 Eleven S, Suite E, Columbia, IL 62236-1077 |
| Craig Schaefer | Physical Therapy | Athletic and Therapeutic Institute of Bourbonnais, LLC | 1000 Eleven S, Suite 1b, Columbia, IL 62236-1078 |
| Elizabeth A Fernandez | Qualified Audiologist | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Jessica M Wachtel | Physician Assistant | Red Bud Clinic Corp | 1000 Eleven S, Suite 2f, Columbia, IL 62236-1079 |
| Erin L Friedman | Internal Medicine | Red Bud Clinic Corp | 1000 Eleven S, Suite 2f, Columbia, IL 62236-1079 |
| Shanna M Witges | Nurse Practitioner | Red Bud Clinic Corp | 1000 Eleven S, Suite 2f, Columbia, IL 62236-1079 |
| Carrie A Daigle | Family Medicine | Red Bud Clinic Corp | 1000 Eleven S, Suite 2f, Columbia, IL 62236-1079 |
| Andrea N Thomas | Physician Assistant | Red Bud Regional Clinic Company LLC | 1000 Eleven S, Suite E, Columbia, IL 62236-1077 |
| Katherine E House | Nurse Practitioner | Orthopedic Associates, LLC | 1000 Eleven S, Suite 3c, Columbia, IL 62236-1077 |
| Mark A Szewczyk | Otolaryngology | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathleen Mcauliffe | Chiropractic | 109 Wedgewood Dr, Columbia, IL 62236-1016 | |
| Laurie R Mestdagh | Chiropractic | 1550 N Main St Unit A, Columbia, IL 62236-1070 | |
| Angela L Tenholder | Oral Surgery | Synergy Therapeutics PC | 1000 Eleven S, Suite 3f, Columbia, IL 62236-1077 |
| Jennifer Flick | Physical Therapy | Athletic and Therapeutic Institute of Bourbonnais, LLC | 1000 Eleven S, Suite 1b, Columbia, IL 62236-1078 |
| Autumn C Gleich | Occupational Therapy | Athletic and Therapeutic Institute of Bourbonnais, LLC | 1000 Eleven S, Suite 1b, Columbia, IL 62236-1078 |
| Ryan M George | Otolaryngology | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Andrew J Nash | Qualified Audiologist | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Richard K Kleinschmidt | Physician Assistant | Ent and Sleep Medicine Associates LLC | 1000 Eleven S, Suite 4f, Columbia, IL 62236-1080 |
| Rachel Margaret Foster | Optometry | 915 N Main St, Suite 1, Columbia, IL 62236-1157 | |
| Kelly K Kerksick | Optometry | Midwest Vision Care of Illinois LLC | 915 N Main St, Columbia, IL 62236-1157 |
| Find all physicians in zip 62236 | |||
| City | COLUMBIA |
| Zip Code | 62236 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | COLUMBIA + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Ketan A 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.