Individual provider Active NPI

Sanjna S Shah, MD

  • Pediatrics Physician
  • Long Branch, NJ
National Provider Identifier
1083956478
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD458197 Issued in OH
Practice address
300 2ND Ave
Long Branch, NJ 07740-6303
Phone
(732) 222-5200
NPI assigned
Mar 23, 2013
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD458197 OH Primary
Hospitalist Physician 208M00000X 25MA10288700 NJ

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6303

Mailing address

300 2ND Ave
Long Branch, NJ 07740-6303
Phone (732) 222-5200

Other practice location 1

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4411

Other practice location 2

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20160830000326 PA Practitioner - Pediatric Medicine 3476855917 Reassigns benefits to 1 organization
I20181130002400 NJ Practitioner - Pediatric Medicine 3476855917 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD458197OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Multispecialty Group Hospitalist CurrentSince Apr 1, 2019 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 15, 2022 Accepting new patients
St Clair Professional Services Inc CurrentSince Aug 1, 2016 Accepting new patients
St Clair Professional Services Inc Pediatrics Current Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 15, 2022 Accepting new patients
St Clair Professional Services Inc Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
Capital Health System, Inc. Past Accepting new patients

Locations

200 Wyckoff Rd
Ste 4200
Eatontown, NJ 07724
Phone (732) 923-6080

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

1000 Bower Hill Rd
Pittsburgh, PA 15243
Phone (412) 344-6600

1000 Bower Hill Rd
Fl 2
Pittsburgh, PA 15243
Phone (412) 942-4272

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5bb47b8f-8587-42a0-80df-8d4eecf69db3/

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1083956478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-222-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-222-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-4411",
            "fax_number": "614-722-6132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "NJ",
            "postal_code": "086384143",
            "country_code": "US",
            "telephone_number": "609-394-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SANJNA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-23",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "MD458197",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA10288700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.