Sudha R Shah

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

133672 Issued in NY

Practice address

3860 Kings Hwy
Brooklyn, NY 11234-2907

Phone

(718) 252-5550

Fax

(718) 258-1768

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1205924974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 BIRCH DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763002",
            "telephone_number": "516-567-6135",
            "fax_number": "718-258-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342907",
            "telephone_number": "718-252-5550",
            "fax_number": "718-258-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUDHA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "133672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00346814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shreya Shah, PT, DPT
• Shukan Shah, D.D.S.
• Shyam Shah, PA-C
• Sneh Shah
• Sneha S Shah, M.D.
• Sudhir Shah, M.D.
• Swarna B Shah, M.D.
• Syed M. Shah, M.D., FACS
• Syed Muhammad Ali Shah
• Taral Ramesh Shah, M.D.

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.