Dinesh Shukla, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

141530 Issued in NY

Practice address

625 Belle Terre Rd
Suite 205
Port Jefferson, NY 11777-2316

Phone

(631) 331-0776

Fax

(631) 473-4760

NPI assigned

Aug 23, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

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

• Long Island Select Healthcare, Inc.

  dba LISH, Inc.

  • Federally Qualified Health Center (FQHC)
  • Central Islip, NY
  • NPI 1043663107
  Medicare reassignment NPD
• Long Island Select Healthcare, Inc.

  dba LISH, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manorville, NY
  • NPI 1518310689
  NPD
• Skills Unlimited, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oakdale, NY
  • NPI 1487789392
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033102280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BELLE TERRE RD",
            "address_2": "SUITE 205",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772316",
            "telephone_number": "631-331-0776",
            "fax_number": "631-473-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BELLE TERRE RD",
            "address_2": "SUITE 205",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772316",
            "telephone_number": "631-331-0776",
            "fax_number": "631-473-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "DINESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "141530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00720892",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Allen MD PLLC
• S Chandra Shekher, MD
• Joshua Adam Sherman, M.D.
• Brittany Lynn Shillingford, LMHC
• Kathryn Shouler, R.D.N
• Sashi Shukla, MD
• Mohammed Rafea Adnan Shukri, MD
• Sawsan K Shukri, D.D.S.
• Francis Richard Sicari, PA-C
• Susan G Silk, O.T.

• Neurology Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.