Individual provider Active NPI

Sharan Jayesh Shah, MD

  • Facial Plastic Surgery Physician
  • Bronx, NY
National Provider Identifier
1144858382
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
335938 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-4646
Fax
(718) 405-9014
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 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
Facial Plastic Surgery Physician 207YS0123X 335938 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4646

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250709001139 NY Practitioner - Otolaryngology 9436663713 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Apr 21, 2025 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Aug 4, 2025 Accepting new patients
TJH Medical Services, P.C. CurrentSince Aug 1, 2025 Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Jul 8, 2025 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Aug 4, 2025 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
L'Refuah Medical & Rehabilitation Center, Inc. Facial Plastic Surgery Past Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

391 Eastern Pkwy
Brooklyn, NY 11216
Phone (718) 613-1600

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

11940 Metropolitan Ave
Kew Gardens, NY 11415
Phone (718) 849-0839

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: sshah845806@nychhc.direct-ci.com

Organizations & group practices 7

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 4

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1144858382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4646",
            "fax_number": "718-405-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4646",
            "fax_number": "718-405-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHARAN",
        "middle_name": "JAYESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "335938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.