Active NPI
Nilay R Shah, M.D.
- Plastic and Reconstructive Surgery Physician
- New York, NY
National Provider Identifier
1043472368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 288544
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 25MA10236700 | NJ | |
| Plastic and Reconstructive Surgery Physician | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA10236700 | NJ | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shah Plastic Surgery PLLC | Single Specialty | Current | Accepting new patients |
| Northeast Plastic Surgery Center LLC | Single Specialty | Current | 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
- nshah68058@northwell.direct-ci.com
- https://fhir4.healow.com/fhir/r4/BFAHBD/Endpoint/BFAHBD
- 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.
-
- Plastic and Reconstructive Surgery Physician
- Old Lyme, CT
- NPI 1932586682
Single Specialty
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.