Active NPI
Amit Shah DPM, LLC
- Foot & Ankle Surgery Podiatrist
- Edison, NJ
National Provider Identifier
1043640568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 25MD00280000
- Legal business name
- AMIT SHAH DPM, LLC
- Practice address
- 619 Amboy Ave
Edison, NJ 08837-3584 - Phone
- (732) 297-9535
- Fax
- (732) 297-8421
- NPI assigned
- Nov 19, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amit K Shah, DPM
- Title
- Physician/Owner
- Phone
- (732) 297-9535
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 25MD00280000 | NJ | Primary |
Addresses
Primary practice location
619 Amboy Ave
Edison, NJ 08837-3584
Mailing address
2864 Route 27 Ste I
North Brunswick, NJ 08902-5010
Phone (732) 297-9535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200311000673 | NJ | DME Supplier - Physician - Podiatry | 7911170360 | Practice locations: Edison, NJ |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384819200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576800000000",
"number": "1043640568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2864 ROUTE 27 STE I",
"city": "NORTH BRUNSWICK",
"state": "NJ",
"postal_code": "089025010",
"telephone_number": "732-297-9535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 AMBOY AVE",
"city": "EDISON",
"state": "NJ",
"postal_code": "088373584",
"telephone_number": "732-297-9535",
"fax_number": "732-297-8421"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMIT SHAH DPM, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-11-19",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "AMIT",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "732-297-9535",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NJ",
"license": "25MD00280000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.