Individual provider Active NPI

Tarun J Shah, M.D.

  • Allergy Physician
  • Sea Girt, NJ
National Provider Identifier
1053385484
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
MA59668 Issued in NJ
Practice address
2130 Highway 35
Suite 115a
Sea Girt, NJ 08750-1010
Phone
(732) 974-9797
Fax
(732) 974-9799
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X MA59668 NJ Primary

Addresses

Primary practice location

2130 Highway 35
Suite 115a
Sea Girt, NJ 08750-1010

Mailing address

2130 Highway 35
Suite 115a
Sea Girt, NJ 08750-1010
Phone (732) 974-9797

Other identifiers 1

IdentifierTypeStateIssuer
5654700MedicaidNJ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090401000046 NJ Practitioner - Allergy/Immunology 9739245085 Practice locations: Old Bridge, NJ; Sea Girt, NJ; Brick, NJ; Bayville, NJ

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Perrine Rd
Suite 209
Old Bridge, NJ 08857-2836
Phone (732) 721-1221

2130 Hwy 35
Sea Girt, NJ 08750-1010
Phone (732) 974-9797

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA59668NJMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1053385484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 HIGHWAY 35",
            "address_2": "SUITE 115A",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087501010",
            "telephone_number": "732-974-9797",
            "fax_number": "732-974-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 HIGHWAY 35",
            "address_2": "SUITE 115A",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087501010",
            "telephone_number": "732-974-9797",
            "fax_number": "732-974-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TARUN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NJ",
            "license": "MA59668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5654700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sea Girt, NJ

Sources for this page

Verify at the official NPI Registry.