Individual provider Active NPI

Rupali Pradip Shah, PA-C

  • Surgical Physician Assistant
  • Newark, NJ
National Provider Identifier
1043408073
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00118000 Issued in NJ
Practice address
201 Lyons Ave
Dept of Cardiothoracic Surgery- G5
Newark, NJ 07112-2027
Phone
(973) 926-8032
Fax
(973) 923-4683
NPI assigned
Oct 3, 2007
Last updated
Oct 3, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00118000 NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Dept of Cardiothoracic Surgery- G5
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave
Dept of Cardiothoracic Surgery- G5
Newark, NJ 07112-2027
Phone (973) 926-8032

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170606000235 NJ Practitioner - Physician Assistant 1052688454 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027

4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone (800) 825-5391

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Oct 1, 2023 Accepting new patients
Valley Physician Services PC CurrentSince Oct 13, 2025 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
#G5
Newark, NJ 07112
Phone (973) 926-7905

Interoperability endpoints

  • Direct secure messaging: rshah229796@epicdirect.rwjbh.org
  • Direct secure messaging: rshah236779@direct.englewoodhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1043408073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "address_2": "DEPT OF CARDIOTHORACIC SURGERY- G5",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-8032",
            "fax_number": "973-923-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "address_2": "DEPT OF CARDIOTHORACIC SURGERY- G5",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-8032",
            "fax_number": "973-923-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RUPALI",
        "middle_name": "PRADIP",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00118000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.