Hinna Ehsanullah Shah, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA08883200 Issued in NJ

Practice address

1411 Broadway FL 10
New York, NY 10018-3496

Phone

(732) 786-3793

NPI assigned

Feb 17, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, PA2 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

Specialty

Psychiatry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Methodist ServicesGroup PAC ID 5193034718, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Methodist Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, PA
  • NPI 1457386328
  Medicare reassignment Care Compare group NPD
• Prairie Du Chien Memorial Hospital Association Inc

  dba Crossing Rivers Health

  • Critical Access Hospital
  • Prairie Du Chien, WI
  • NPI 1619024197
  Medicare reassignment NPD
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physician Group, Inc.

  dba St. Luke's Psychiatric Associates - Bowmanstown

  • Psychiatry Physician
  • Bowmanstown, PA
  • NPI 1376107235
  NPD

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1083911598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "BLDG A, SUITE 367",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-786-3793",
            "fax_number": "732-845-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 BROADWAY FL 10",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183496",
            "telephone_number": "732-786-3793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 W Main St",
            "address_2": "Bldg A, Suite 367",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077282537",
            "country_code": "US",
            "telephone_number": "732-786-3793",
            "fax_number": "732-845-5407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "HINNA",
        "middle_name": "EHSANULLAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA08883200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gunjan Lalitchandra Shah, MD
• Haresh Shah, R.PH
• Harsh Shah, MD, MPH, MS
• Hasmukh G Shah, BS
• Hemali Shah
• Hiral Gautam Shah, MD
• Hiten Shah, RPH
• Hyder Shah, MD
• Jalpen Shah
• Jatin P Shah, MD

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.