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Deactivated NPI 1154512127 Deactivated / Inactive NPI Male Practitioner

Dr. Kunvarji Gangji Shah , MD

Plastic Surgery • Peoria, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kunvarji Shah has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 06, 2007
NPI Deactivation Date January 28, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Kunvarji Shah, MD was a registered Plastic Surgery practicing in Peoria, IL. Throughout an active medical career spanning 13 years, Dr. Shah provided care at the practice location at 802 W TRAILCREEK DR until profile deactivation on 2020-01-28.

Practice Location & Contact Primary Location

Practice Address

802 W Trailcreek Dr

Peoria, IL 616141862

Telephone 3096923630

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.5 Yrs
State Avg: 24.3 Yrs
Regional Practice Density
6 Specialists

Practicing in Peoria, IL (236 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Jenny Shah , CRNA APN

Nurse Anesthetist, Certified Registered

NPI 1285802678

CRNAAPN

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 28, 2020

Record deactivated on January 28, 2020

NPI Profile Active August 06, 2007

NPI status registered as active in NPPES database

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Updated Practice Location August 06, 2007

Registered at 802 W TRAILCREEK DR, PEORIA, IL 616141862 (Tel: 3096923630)

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Updated Business Mailing Address August 06, 2007

Registered at 802 W TRAILCREEK DR, PEORIA, IL 616141862 (Tel: 3096923630)

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Provider Name / Credentials Updated August 06, 2007

Recorded as KUNVARJI SHAH, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 06, 2007

Plastic Surgery

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Initial NPI Registration & Enumeration August 06, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154512127
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 06, 2007
Last Update: August 06, 2007
Deactivation Date: January 28, 2020

Mailing Address

802 W Trailcreek Dr

Peoria, IL 616141862

Phone: 3096923630

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.