Individual provider Active NPI

Nishit Shah

  • Colon & Rectal Surgery Physician
  • Providence, RI
National Provider Identifier
1023052537
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD12780 Issued in RI
Practice address
208 Collyer St
Suite 302
Providence, RI 02904-1560
Phone
(401) 553-8322
Fax
(401) 868-2315
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 010123650 VA
Colon & Rectal Surgery Physician 208C00000X MD12780 RI Primary

Addresses

Primary practice location

208 Collyer St
Suite 302
Providence, RI 02904-1560

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nish.shah@usasurg.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210622002299 CA Practitioner - Colorectal Surgery (Proctology) 7618958992 Reassigns benefits to 1 organization
I20260414001110 NY Practitioner - General Surgery 7618958992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504

2758 Middle Country Rd
Lake Grove, NY 11755-2118

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD12780RIMDColon & Rectal Surgery Physician
010123650VAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Apr 30, 2021 Accepting new patients
Pih Health Physicians CurrentSince Apr 30, 2021 Accepting new patients
MCV Associated Physicians PastSince Sep 28, 2021 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

11500 Brookshire Ave
Downey, CA 90241
Phone (562) 904-5000

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1245 Wilshire Blvd
Ste 905
Los Angeles, CA 90017
Phone (213) 481-0584

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

6557 Greenleaf Ave
Whittier, CA 90601
Phone (562) 789-5401

12462 Putnam St
Ste 500
Whittier, CA 90602
Phone (562) 789-5449

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

Networks

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

Interoperability endpoints

  • Direct secure messaging: nshah8535854@nychhc.direct-ci.com
  • Direct secure messaging: nishitshah@pihh.allscriptsdirect.net
  • Direct secure messaging: nish.shah@usasurg.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1023052537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLLYER ST",
            "address_2": "SUITE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041560",
            "telephone_number": "401-553-8322",
            "fax_number": "401-868-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NISHIT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "VA",
            "license": "010123650",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "RI",
            "license": "MD12780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nish.shah@usasurg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "208 Collyer St",
            "address_2": "Suite 302",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029041560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.