Individual provider Active NPI

Michelle Shah, DO

  • Gastroenterology Physician
  • New York, NY
National Provider Identifier
1104386002
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MB12621000 Issued in NJ
Practice address
281 1St Ave
New York, NY 10003-2925
Phone
(212) 420-2000
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 25MB12621000 NJ Primary

Addresses

Primary practice location

281 1St Ave
New York, NY 10003-2925

Mailing address

1400 Pelham Pkwy S
Bronx, NY 10461-1138

Other practice location 1

1400 Pelham Pkwy S
Bronx, NY 10461-1138
Phone (718) 918-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20251031002885 NJ Practitioner - Internal Medicine 2163753997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB12621000NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Aug 21, 2025 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Aug 21, 2025 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

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

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

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1 Robert Wood Johnson Pl
Fl 2
New Brunswick, NJ 08901

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1104386002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032925",
            "telephone_number": "212-420-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pelham Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611138",
            "country_code": "US",
            "telephone_number": "718-918-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MB12621000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.