Active NPI
Dhara Shah
- Cardiovascular Disease Physician
- Montclair, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 25MB11460800
- Practice address
- 62 S Fullerton Ave
Montclair, NJ 07042-2676 - Phone
- (973) 746-8585
- Fax
- (973) 746-0088
- NPI assigned
- Apr 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 25MB11460800 | NJ | Primary |
Addresses
Primary practice location
62 S Fullerton Ave
Montclair, NJ 07042-2676
Mailing address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Rowan University School of Osteopathic Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group PA | Current | Accepting new patients | |
| Summit Medical Group PA | Current | Accepting new patients | |
| Summit Medical Group, Inc | Past | Accepting new patients |
Locations
1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868
67 Walnut Ave
Clark, NJ 07066
Phone (732) 388-7300
Interoperability endpoints
- dhara.shah.1@2983.direct.athenahealth.com
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.
-
- Multi-Specialty Clinic/Center
- Berkeley Heights, NJ
- NPI 1942254347
-
- Durable Medical Equipment & Medical Supplies
- Hackensack, NJ
- NPI 1043930555
-
dba St. Elizabeth Physicians
- Family Medicine Physician
- Erlanger, KY
- NPI 1750343216
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Livingston, NJ
- NPI 1396857488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1255795613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 DIAMOND HILL RD",
"city": "BERKELEY HEIGHTS",
"state": "NJ",
"postal_code": "079222104",
"telephone_number": "908-273-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 S FULLERTON AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422676",
"telephone_number": "973-746-8585",
"fax_number": "973-746-0088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "DHARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-11",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NJ",
"license": "25MB11460800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.
- 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.