Individual provider Active NPI

Anjali Shah, M.D.

  • Diagnostic Radiology Physician
  • Menlo Park, CA
National Provider Identifier
1083054142
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A160980 Issued in CA
Practice address
1300 Crane St
Menlo Park, CA 94025-4260
Phone
(888) 924-1036
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A160980 CA Primary

Addresses

Primary practice location

1300 Crane St
Menlo Park, CA 94025-4260

Mailing address

1300 Crane St
Menlo Park, CA 94025-4260
Phone (888) 924-1036

Other practice location 1

355 Bard Ave
Staten Island, NY 10310-1664
Phone (516) 643-8229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230427001611 NY Practitioner - Diagnostic Radiology 7618203589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lenox Hill Radiology and Medical Imaging Associates PCGroup PAC ID 2264424712, 245 clinicians

Practice addresses (Care Compare)

61 E 77TH St
New York, NY 10075-1817
Phone (212) 772-3111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160980CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology CurrentSince Jun 1, 2023 Accepting new patients
Hudson Valley Radiology Associates PLLC Diagnostic Radiology CurrentSince Jun 1, 2023 Accepting new patients
New York Private Medical Imaging Practice, PLLC Past Accepting new patients
Park West Radiology, PC Diagnostic Radiology PastSince Jul 1, 2008 Accepting new patients

Locations

27443 Network Pl
Chicago, IL 60673

345 Woodcliff Dr
Ste 2A
Fairport, NY 14450

8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532

18 Squadron Blvd
New City, NY 10956
Phone (845) 368-3002

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300

Interoperability endpoints

  • Direct secure messaging: ashah456926@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1083054142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CRANE ST",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254260",
            "telephone_number": "888-924-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CRANE ST",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254260",
            "telephone_number": "888-924-1036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Bard Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103101664",
            "country_code": "US",
            "telephone_number": "516-643-8229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANJALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A160980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.