Individual Healthcare Provider
Pratish Ajay Shah, MD
Provider's NPPES record last updated: April 22, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1104142512
- Primary Specialty
- Radiology — Neuroradiology
- Practice Location
- Springfield, Illinois
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 3:15 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Radiology
Neuroradiology
Allopathic & Osteopathic Physicians
A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
Taxonomy code 2085N0700X Radiology
Diagnostic Radiology
Allopathic & Osteopathic Physicians
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Taxonomy code 2085R0202X
Provider-Reported License Information
- Radiology (Illinois)
- 036137694
- Radiology (North Carolina)
- 2020-02657
- Radiology (North Carolina)
- 2020-02657
Practice Locations
Practice Location
1025 S 6th St
Springfield, Illinois 62703-2499
Phone: (217) 528-7541
Additional Practice Location
3186 Village Dr Ste 201
Fayetteville, North Carolina 28304-3979
Phone: (910) 486-5700
Fax: (910) 486-5950
Record Information
- Enumeration Date
- April 9, 2010
- Provider's NPPES Record Last Updated
- April 22, 2026
- Certification Date
- April 22, 2026
- NPISignal NPPES Dataset
- August 2026
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