Individual provider Active NPI

Neena Shah, MD

  • Internal Medicine Physician
  • Jackson Heights, NY
National Provider Identifier
1275626210
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
225426 Issued in NY
Practice address
3304 93Rd St
Suite 1W
Jackson Heights, NY 11372
Phone
(718) 335-4747
Fax
(718) 476-2626
NPI assigned
Oct 2, 2006
Sex
Female
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
Internal Medicine Physician 207R00000X 225426 NY Primary

Addresses

Primary practice location

3304 93Rd St
Suite 1W
Jackson Heights, NY 11372

Mailing address

3304 93Rd St
Suite 1W
Jackson Heights, NY 11372
Phone (718) 335-4747

Other identifiers 1

IdentifierTypeStateIssuer
02512605MedicaidNY

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
I20040206000294 NY Practitioner - Geriatric MedicinePractitioner - Internal Medicine 4587557178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Internal Medicine Group PCGroup PAC ID 5496647208, 5 clinicians

Practice addresses (Care Compare)

2200 Northern Blvd
Suite 133
Greenvale, NY 11548-1226
Phone (516) 352-8100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Internal Medicine Group PC Internal Medicine CurrentSince Feb 10, 2020 Accepting new patients
Digestive Disease Care, PC Past Accepting new patients
CHS Physician Partners, P.C PastSince Feb 10, 2020 Accepting new patients
Queens Medical Services PLLC Internal Medicine PastSince Jan 1, 1990 Accepting new patients
Gastrohealth Medical P.C. Past Accepting new patients
St. Francis Hospital Past Accepting new patients

Locations

2200 Northern Blvd
Ste 133
Greenvale, NY 11548
Phone (516) 352-8100

3003 New Hyde Park Rd
Ste 201A
New Hyde Park, NY 11042
Phone (516) 352-8100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEDHAD
  • FHIR API: https://api.platform.athenahealth.com/21626/brand/2/csg/1/fhir/r4

Organizations & group practices 6

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 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275626210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 93RD ST",
            "address_2": "SUITE 1W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-335-4747",
            "fax_number": "718-476-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 93RD ST",
            "address_2": "SUITE 1W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-335-4747",
            "fax_number": "718-476-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NEENA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "225426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02512605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.