Shrenik G Shah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA 44420 Issued in NJ

Practice address

55 W Passaic Ave
Bloomfield, NJ 07003-4502

Phone

(973) 338-8059

Fax

(973) 338-6013

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Union County Health Care Associates LLC

  • Internal Medicine Physician
  • Garwood, NJ
  • NPI 1033271291
  Medicare reassignment NPD

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1053352732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034502",
            "telephone_number": "973-338-8059",
            "fax_number": "973-338-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034502",
            "telephone_number": "973-338-8059",
            "fax_number": "973-338-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHRENIK",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA 44420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "463751473",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4699106",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1922435585",
            "identifier": "318777",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selmar Drug Co (Center Drug Store)
• Serenity Senior Care
• Carlos Serrano, MS, APRN, CPNP-PC
• Ajit M. Shah, M.D.
• Madhavi Shah, MD
• Matthew Shahbandi, MD
• Amanda Shaw
• Saty Hemdan Sherif, RPH
• Nima Nuru Sherpa
• Allison Sherwood, APN

• Internal Medicine Physician in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.

Verify at the official NPI Registry.