Individual provider Active NPI

Shipra Shah, M.D.

  • Internal Medicine Physician
  • Wayne, NJ
National Provider Identifier
1154689156
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA09692000 Issued in NJ
Practice address
1680 Route 23 Ste 160
Wayne, NJ 07470-7512
Phone
(973) 221-2500
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA09692000 NJ Primary

Addresses

Primary practice location

1680 Route 23 Ste 160
Wayne, NJ 07470-7512

Mailing address

1680 Route 23 Ste 160
Wayne, NJ 07470-7512
Phone (973) 221-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150819008276 NJ Practitioner - Internal Medicine 3476868407 Reassigns benefits to 1 organization
I20170724000734 NY Practitioner - Internal MedicinePractitioner - Hospitalist 3476868407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1680 Route 23
Suite 160
Wayne, NJ 07470-7512
Phone (646) 504-6007

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Medical Care PC Internal Medicine CurrentSince Jun 17, 2017 Accepting new patients
Shah Primary Care Internal Medicine CurrentSince Apr 30, 2021 Accepting new patients

Locations

1680 Route 23
Ste 160
Wayne, NJ 07470
Phone (646) 504-6007

70 Dubois St
Fl 2
Newburgh, NY 12550
Phone (845) 561-4400

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

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 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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1154689156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ROUTE 23 STE 160",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707512",
            "telephone_number": "973-221-2500",
            "fax_number": "973-284-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ROUTE 23 STE 160",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707512",
            "telephone_number": "973-221-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHIPRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09692000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.