Individual provider Active NPI

Roshni Shah, CPNP

  • Pediatric Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1003492042
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383186 Issued in NY
Practice address
7901 Broadway # A1-19
Elmhurst, NY 11373-1329
Phone
(718) 334-3501
Fax
(718) 334-5006
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383186 NY Primary

Addresses

Primary practice location

7901 Broadway # A1-19
Elmhurst, NY 11373-1329

Mailing address

7901 Broadway # A1-19
Elmhurst, NY 11373-1329
Phone (718) 334-3501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725001678 NY Practitioner - Clinical Social Worker 8527504638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
383186NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Jul 1, 2024 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 1, 2024 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: rshah92364@nyumc.direct-ci.com
  • Direct secure messaging: rshah4527883@nychhc.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1003492042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY # A1-19",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3501",
            "fax_number": "718-334-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY # A1-19",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-3501",
            "fax_number": "718-334-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ROSHNI",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.