Kulsoom Shah, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

224192-1 Issued in NY

Practice address

1 Stadium Rd,Student Health Center,Stonybrook Univ
Stony Brook, NY 11794-0001

Phone

(631) 632-6740

Fax

(631) 632-6936

NPI assigned

May 23, 2005

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114920360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 AVALON CIR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873855",
            "telephone_number": "631-863-1634",
            "fax_number": "631-632-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 STADIUM RD,STUDENT HEALTH CENTER,STONYBROOK UNIV",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-632-6740",
            "fax_number": "631-632-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KULSOOM",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "224192-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdy Shawky Shady, M.D.
• Shafi Wani,M.D.,P.C.
• Aadit Shah, MD
• Apurva J. Shah, M.D.
• Ashkin Shah
• Neal Shah, MD
• Nidhi Jayesh Shah, MD
• Riya Shah
• Rohan Shah, MD
• Shetal Shah

• Family Medicine Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.