Organization Active NPI

Amit Shah DPM, LLC

  • Foot & Ankle Surgery Podiatrist
  • Edison, NJ
National Provider Identifier
1043640568
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00280000 Issued in NJ
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

Updated by the provider on Dec 20, 2019

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)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 Directory

NPI 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.

Verify at the official NPI Registry.