Individual provider Active NPI

Shivani Shah, M.D.

  • Obstetrics & Gynecology Physician
  • Wilkes Barre, PA
National Provider Identifier
1053721597
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD465099 Issued in PA
Practice address
1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone
(570) 808-7916
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD465099 PA Primary

Addresses

Primary practice location

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

Msc 10 5580
1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-9474

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshah169549@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220112000035 MD Practitioner - Obstetrics/Gynecology 0648497685 Reassigns benefits to 1 organization
I20220222000211 DE Practitioner - Obstetrics/Gynecology 0648497685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-6662

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County, Inc CurrentSince Jan 5, 2022 Accepting new patients
Christiana Care Health Services Inc CurrentSince Feb 15, 2022 Accepting new patients
Union Hospital of Cecil County Obstetrics & Gynecology CurrentSince Jan 5, 2022 Accepting new patients
Christiana Care Health Services Inc Obstetrics & Gynecology CurrentSince Feb 15, 2022 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services, Inc. Past Accepting new patients
Union Hospital of Cecil County Past Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients

Locations

4755 Oglewtown Stant S 190
Newark, DE 19718
Phone (302) 733-6510

4755 Ogletown Stanton Rd
Ste 1900
Newark, DE 19718
Phone (302) 733-6510

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Interoperability endpoints

  • Direct secure messaging: sshah169549@direct.geisinger.edu

Organizations & group practices 8

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 1

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1053721597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027906",
            "telephone_number": "570-808-7916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc 10 5580",
            "address_2": "1 University of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-9474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHIVANI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD465099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshah169549@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1155 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187027906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.