Individual provider Active NPI

Shashi S Shah, MD

  • Urology Physician
  • Valley Stream, NY
National Provider Identifier
1174521710
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
130215 Issued in NY
Practice address
525 N Central Ave
Valley Stream, NY 11580-1136
Phone
(516) 825-5505
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 130215 NY Primary

Addresses

Primary practice location

525 N Central Ave
Valley Stream, NY 11580-1136

Mailing address

525 N Central Ave
Valley Stream, NY 11580-1136
Phone (516) 825-5505

Other identifiers 1

IdentifierTypeStateIssuer
00523386MedicaidNY

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
I20110603000451 NY Practitioner - Urology 2567649387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

733 Sunrise Hwy
Lynbrook, NY 11563-2921
Phone (516) 734-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130215NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Urology CurrentSince Jun 24, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jun 24, 2019 Accepting new patients

Locations

865 Merrick Rd
Ste 205
Baldwin, NY 11510
Phone (516) 378-9420

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

17660 Union Tpke
Ste 200
Fresh Meadows, NY 11366
Phone (646) 742-8800

733 Sunrise Hwy
Lynbrook, NY 11563
Phone (516) 593-3535

300 Community Dr
Manhasset, NY 11030

14 Technology Dr
Setauket, NY 11733
Phone (516) 444-1357

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

972 Brush Hollow Rd
Westbury, NY 11590

222 Westchester Ave
Ste G1
White Plains, NY 10604
Phone (877) 465-4845

Networks

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

Interoperability endpoints

  • Direct secure messaging: shashishah@nslijmedgr.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174521710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N CENTRAL AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801136",
            "telephone_number": "516-825-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N CENTRAL AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801136",
            "telephone_number": "516-825-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHASHI",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "130215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00523386",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.