Individual provider Active NPI

Nili Shah

  • Occupational Therapist
  • Monroe Township, NJ
National Provider Identifier
1154890952
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00488000 Issued in NJ
Practice address
18 Centre Dr
Monroe Township, NJ 08831-1501
Phone
(609) 770-4181
Fax
(609) 655-4201
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00488000 NJ Primary

Addresses

Primary practice location

18 Centre Dr
Monroe Township, NJ 08831-1501

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191120002642 NJ Practitioner - Occupational Therapist in Private Practice 1557606456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

79 Hudson St
Hoboken, NJ 07030-5638
Phone (201) 792-1170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46TR00488000NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc Occupational Therapist CurrentSince Nov 19, 2018 Accepting new patients
Ivyrehab Network, Inc. Occupational Therapist CurrentSince Nov 19, 2018 Accepting new patients
Ivyrehab Network Inc. Occupational Therapist Current Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

79 Hudson St
Hoboken, NJ 07030
Phone (201) 792-1170

18 Centre Dr
Monroe Twp, NJ 08831
Phone (609) 655-4200

80 Mill St
#1
Newton, NJ 07860
Phone (973) 940-7311

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1154890952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CENTRE DR",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088311501",
            "telephone_number": "609-770-4181",
            "fax_number": "609-655-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NILI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00488000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.