Individual provider Active NPI

Geeta Mohla Shah, M.D.

  • Procedural Dermatology Physician
  • Chevy Chase, MD
National Provider Identifier
1194773770
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
D0064140 Issued in MD
Practice address
5471 Wisconsin Ave Ste 200
Chevy Chase, MD 20815-3546
Phone
(301) 798-9699
Fax
(240) 802-2993
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X D0064140 MD Primary

Addresses

Primary practice location

5471 Wisconsin Ave Ste 200
Chevy Chase, MD 20815-3546

Mailing address

5471 Wisconsin Ave Ste 200
Chevy Chase, MD 20815-3546
Phone (301) 798-9699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2016 through Oct 1, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0064140MDMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laser & Skin Surgery Medical Group Inc Procedural Dermatology PastSince Oct 6, 1997 Accepting new patients

Organizations & group practices 1

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1194773770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 WISCONSIN AVE STE 200",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153546",
            "telephone_number": "301-798-9699",
            "fax_number": "240-802-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 WISCONSIN AVE STE 200",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153546",
            "telephone_number": "301-798-9699",
            "fax_number": "240-802-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "GEETA",
        "middle_name": "MOHLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MD",
            "license": "D0064140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.