Nidhi Malav Shah

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

291597 Issued in CA

Practice address

373 Pine LN
Los Altos, CA 94022-1694

Phone

(650) 209-3530

NPI assigned

Mar 13, 2024

Sex

Female

Sole proprietor

No

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premere Rehab LLCGroup PAC ID 2567434764, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Premere Rehab LLC

  • Physical Therapist
  • Wilsonville, OR
  • NPI 1245278639

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1093573016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 PINE LN",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221694",
            "telephone_number": "650-209-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 PINE LN",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221694",
            "telephone_number": "650-209-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NIDHI",
        "middle_name": "MALAV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sejla Serifovic
• Gina Serraiocco, MD
• Ramya Sethuram, MD
• Shadduck - Physical Therapy Works Inc
• Kristin Tyse Shadduck, PT
• Sagar Vinod Shah, D.D.S.
• Natalie Shahar, LMFT
• Maytal Shalev-Eylath
• Yihsin Megan Shang, R.PH.
• Jerrold Lee Shapiro, PH.D.

• Physical Therapist in Los Altos, CA
• Providers in Los Altos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.