NPIMap

Individual provider Active NPI

Parul Jaikrishna Shukla, M.D.

  • Colon & Rectal Surgery Physician
  • New York, NY
National Provider Identifier
1053671826
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
265299 Issued in NY
Practice address
1300 York Ave
K-802E
New York, NY 10065-4805
Phone
(646) 962-2353
NPI assigned
May 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 265299 NY Primary

Addresses

Primary practice location

1300 York Ave
K-802E
New York, NY 10065-4805

Mailing address

1161 York Ave
Apt 11C
New York, NY 10065-7940
Phone (917) 833-4718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120810000092 NY Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 4587810387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261
  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162
  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jun 25, 2012 Accepting new patients
North Shore-Lij Medical PC Colon & Rectal Surgery CurrentSince Jul 1, 2022 Accepting new patients
Weill Medical College of Cornell CurrentSince Jun 25, 2012 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2022 Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients

Locations

480 Bedford Rd
Chappaqua, NY 10514
Phone (866) 997-5781

480 Bedford Rd
Ste 1
Chappaqua, NY 10514

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

122 E 76th St
Ofc 1B
New York, NY 10021
Phone (212) 628-8771

50 E 69th St
New York, NY 10021
Phone (212) 570-4000

122 E 76th St
New York, NY 10021
Phone (212) 434-2878

1300 York Ave
#K802E
New York, NY 10065
Phone (646) 962-2353

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

777 N Broadway
Ste 204
Sleepy Hollow, NY 10591
Phone (914) 631-0290

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: pshukla65062@northwell.direct-ci.com
  • Direct secure messaging: pas2026@direct.nyp.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1053671826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 YORK AVE",
            "address_2": "APT 11C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657940",
            "telephone_number": "917-833-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK AVE",
            "address_2": "K-802E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654805",
            "telephone_number": "646-962-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "PARUL",
        "middle_name": "JAIKRISHNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "265299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.