Individual provider Active NPI

Neal Shah, DPT

  • Physical Therapist
  • Morris Plains, NJ
National Provider Identifier
1104248350
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01655200 Issued in NJ
Practice address
15 Coogan CT
Morris Plains, NJ 07950-2553
Phone
(973) 634-3966
NPI assigned
Jan 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 009978 CT
Physical Therapist 225100000X 40QA01655200 NJ Primary

Addresses

Primary practice location

15 Coogan CT
Morris Plains, NJ 07950-2553

Mailing address

15 Coogan CT
Morris Plains, NJ 07950-2553
Phone (973) 634-3966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302000227 NJ Practitioner - Physical Therapist in Private Practice 9739484601 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maywood in Motion Physical Therapy and WellnessGroup PAC ID 5496295651, 2 clinicians

Practice addresses (Care Compare)

37 Brook Ave
Maywood, NJ 07607-1130
Phone (973) 634-3966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009978CTMDSocial Worker
40QA01655200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scordilis Family Chiropractic, PA CurrentSince Oct 11, 2022 Accepting new patients
Maywood in Motion Physical Therapy and Wellness Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients
Joseph Licitra DC LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

300 Broadacres Dr
Ste 126
Bloomfield, NJ 07003
Phone (973) 272-5978

300 Broadacres Dr
Ste 126C
Bloomfield, NJ 07003

300 Broadacres Dr
Ste 126A
Bloomfield, NJ 07003
Phone (973) 470-0632

925 Allwood Rd
Clifton, NJ 07012
Phone (973) 777-7638

37 Brook Ave
Ste 100
Maywood, NJ 07607

37 Brook Ave
Maywood, NJ 07607
Phone (201) 291-8811

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": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1104248350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 COOGAN CT",
            "city": "MORRIS PLAINS",
            "state": "NJ",
            "postal_code": "079502553",
            "telephone_number": "973-634-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COOGAN CT",
            "city": "MORRIS PLAINS",
            "state": "NJ",
            "postal_code": "079502553",
            "telephone_number": "973-634-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NEAL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-07",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009978",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01655200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris Plains, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.