NPIMap

Individual provider Active NPI

Sovrin M Shah, MD

  • Urology Physician
  • New York, NY
National Provider Identifier
1245211663
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2110611 Issued in NY
Practice address
10 Union Square East
Suite 3a Bimc Dept of Urology
New York, NY 10003
Phone
(212) 844-8926
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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 2110611 NY Primary

Addresses

Primary practice location

10 Union Square East
Suite 3a Bimc Dept of Urology
New York, NY 10003

Mailing address

PO Box 95000-2227
Philadelphia, PA 19195-2227
Phone (212) 844-8926

Other identifiers 1

IdentifierTypeStateIssuer
02573435MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040817000960 NY Practitioner - Urology 0749253870 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
State University of New York at Stony Brook, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

10 Union SQ E
New York, NY 10003-3314
Phone (212) 844-8929

1000 10TH Ave
New York, NY 10019-1147
Phone (212) 781-9697

1200 S Ave
Suite 301
Staten Island, NY 10314-3420
Phone (718) 370-1400

One Gustave L Levy Place
New York, NY 10029-6574
Phone (212) 241-0045

Hospital & facility affiliations

  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai West Hospital, New York, NY, CCN 330046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2110611NYMDUrology Physician

Practice roles (11 of 15)

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Jan 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince Jan 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince Jan 1, 2016 Accepting new patients
Amboy Medical Practice PC Urology CurrentSince Jan 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Docs Physicians Affiliated With Bimc Urology Past Accepting new patients
Beth Israel Medical Center Urology Past Accepting new patients
Bimc Faculty Practice Urology Past Accepting new patients

Locations

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

10 Union Sq E
Ste 3A
New York, NY 10003
Phone (212) 844-8100

10 Union Sq E
#3A
New York, NY 10003
Phone (212) 241-4812

67 Irving Pl
Fl 10
New York, NY 10003
Phone (212) 254-5350

150 E 42nd St
#5
New York, NY 10017
Phone (212) 523-5898

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1200 South Ave
Ste 301
Staten Island, NY 10314
Phone (718) 370-1400

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: sovrin.shah.1@19656.direct.athenahealth.com

Organizations & group practices 11

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 11

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1245211663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2227",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952227",
            "telephone_number": "212-844-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQUARE EAST",
            "address_2": "SUITE 3A BIMC DEPT OF UROLOGY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-844-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SOVRIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "2110611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02573435",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.