Active NPI
Radhika Shah
- Medical Physician Assistant
- Prospect Park, NJ
National Provider Identifier
1003696808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 240 N 8TH St
Prospect Park, NJ 07508-2002 - Phone
- (973) 942-2131
- NPI assigned
- Sep 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
240 N 8TH St
Prospect Park, NJ 07508-2002
Mailing address
240 N 8TH St
Prospect Park, NJ 07508-2002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Future Pediatric Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Prospect Park, NJ
- NPI 1649462995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695945600000",
"number": "1003696808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N 8TH ST",
"city": "PROSPECT PARK",
"state": "NJ",
"postal_code": "075082002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 N 8TH ST",
"city": "PROSPECT PARK",
"state": "NJ",
"postal_code": "075082002",
"telephone_number": "973-942-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "RADHIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-29",
"last_updated": "2023-09-29",
"certification_date": "2023-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prospect Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.