Individual provider Active NPI

Nilay R Shah, M.D.

  • Plastic and Reconstructive Surgery Physician
  • New York, NY
National Provider Identifier
1043472368
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
288544 Issued in NY
Practice address
330 E 38TH St Apt 20O
New York, NY 10016-0358
Phone
(914) 341-2702
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 25MA10236700 NJ
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 288544 NY Primary

Addresses

Primary practice location

330 E 38TH St Apt 20O
New York, NY 10016-0358

Mailing address

330 E 38TH St Apt 20O
New York, NY 10016-0358
Phone (914) 341-2702

Other practice location 1

13400 E Shea Blvd
Scottsdale, AZ 85259-5452
Phone (480) 301-8000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210420000761 NY Practitioner - Plastic and Reconstructive Surgery 3274771647 Practice locations: New York, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10236700NJMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shah Plastic Surgery PLLC Single Specialty CurrentSince May 31, 2020 Accepting new patients
Northeast Plastic Surgery Center LLC Single Specialty CurrentSince Apr 17, 2019 Accepting new patients

Locations

5 Davis Rd E
Old Lyme, CT 06371
Phone (860) 390-6000

352 7th Ave
Rm 1503
New York, NY 10001
Phone (646) 894-1830

Networks

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

Interoperability endpoints

  • Direct secure messaging: nshah68058@northwell.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BFAHBD/Endpoint/BFAHBD
  • Direct secure messaging: nshah19665@sbhny.direct-ci.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043472368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E 38TH ST APT 20O",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160358",
            "telephone_number": "914-341-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E 38TH ST APT 20O",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160358",
            "telephone_number": "914-341-2702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595452",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NILAY",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA10236700",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "288544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.