Individual provider Active NPI

Kankshinee Piyushkumar Shah

  • Student in an Organized Health Care Education/Training Program
  • Jackson Heights, NY
National Provider Identifier
1124612197
Registry record updated Feb 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3508 95TH St Apt 2C
Jackson Heights, NY 11372-6040
Phone
(845) 326-6272
NPI assigned
Feb 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3508 95TH St Apt 2C
Jackson Heights, NY 11372-6040

Mailing address

3508 95TH St Apt 2C
Jackson Heights, NY 11372-6040
Phone (845) 326-6272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210720001204 LA Order and Referring Only - DentistPractitioner - Dentist 5698178275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1124612197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 95TH ST APT 2C",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726040",
            "telephone_number": "845-326-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 95TH ST APT 2C",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726040",
            "telephone_number": "845-326-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KANKSHINEE",
        "middle_name": "PIYUSHKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.