Essex Digestive Healthcare PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

ESSEX DIGESTIVE HEALTHCARE PC

Practice address

2060 Millburn Ave
Maplewood, NJ 07040-3713

Phone

(973) 642-3155

Fax

(973) 642-0047

NPI assigned

Sep 16, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Amol Shah, MDNPI 1912347030

Title

Owner

Phone

(973) 634-2184

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amol R Shah, MD

  • Gastroenterology Physician
  • Newark, NJ
  • NPI 1912347030
  Medicare reassignment NPD Authorized official
• Molisha Patel, M.S., PA-C

  • Physician Assistant
  • Hillsborough, NJ
  • NPI 1750637138
  NPD (past)

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1033889589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W MCCLELLAN AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391245",
            "telephone_number": "973-642-3155",
            "fax_number": "973-642-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 MILLBURN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403713",
            "telephone_number": "973-642-3155",
            "fax_number": "973-642-0047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1060 Broad St Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071022321",
            "country_code": "US",
            "telephone_number": "973-642-3155",
            "fax_number": "973-642-0047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ESSEX DIGESTIVE HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "AMOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-634-2184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912347030",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MDNet",
            "affiliation": "N",
            "address_1": "1060 Broad St Ste 2A",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071022321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Michael Erwin
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• Esther O Udechukwu
• Jessica Lynne Estreicher, LSW
• Danielle Etienne, RN
• Syvon Evans

• Gastroenterology Physician in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.