NPIMap

Individual provider Active NPI

Rida Ezehra Shah, M.D

  • Internal Medicine Physician
  • Plymouth Meeting, PA
National Provider Identifier
1063892255
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD470170 Issued in PA
Practice address
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone
(646) 683-0907
NPI assigned
Jun 3, 2015
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD470170 PA Primary

Addresses

Primary practice location

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324

Mailing address

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (646) 683-0907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200618002375 PA Practitioner - Internal Medicine 3870915903 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians
Suburban Geriatric's, Inc.Group PAC ID 4486551371, 102 clinicians
Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians

Practice addresses (Care Compare)

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 566-9400

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD470170PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Pennsylvania PC Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Suburban Geriatrics II PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
CS Pacs 3 Northeast, LLC CurrentSince Sep 9, 2024 Accepting new patients
Violet Valley Long Term Care PC CurrentSince Aug 18, 2025 Accepting new patients
Inpatient Consultants of Pennsylvania PC Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Suburban Geriatrics, Inc. Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
NJ Pacs 2 PA CurrentSince Sep 1, 2023 Accepting new patients
Main Line Healthcare Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Providence Operator LLC Past Accepting new patients
115 S Providence Road Operations LLC Past Accepting new patients
Sterling Healthcare & Rehab Center LLC Past Accepting new patients
Kearsley Operator LP Past Accepting new patients
Bryn Mawr Healthcare Group, LLC Past Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

956 E Railroad Ave
Bryn Mawr, PA 19010
Phone (610) 525-8412

1412 Lansdowne Ave
Darby, PA 19023
Phone (610) 461-6510

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

318 S Orange St
Media, PA 19063
Phone (610) 566-1400

1526 Lombard St
Philadelphia, PA 19146
Phone (215) 546-5960

2600 Belmont Ave
Philadelphia, PA 19131
Phone (215) 581-0705

2901 Jolly Rd
Plymouth Mtng, PA 19462
Phone (610) 272-3222

720 Blackburn Rd
Sewickley, PA 15143
Phone (412) 741-6600

2815 Byberry Rd
Uppr Moreland, PA 19040
Phone (215) 292-5008

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 11

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": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1063892255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "646-683-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "646-683-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RIDA",
        "middle_name": "EZEHRA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD470170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.