NPIMap

Individual provider Active NPI

Pradip S Shah, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • West Caldwell, NJ
National Provider Identifier
1326059320
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MA062084 Issued in NJ
Practice address
459 Passaic Ave
Crane's Mill - Oak Health Center
West Caldwell, NJ 07006-7457
Phone
(973) 276-3026
Fax
(973) 276-7881
NPI assigned
Aug 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MA062084 NJ Primary

Addresses

Primary practice location

459 Passaic Ave
Crane's Mill - Oak Health Center
West Caldwell, NJ 07006-7457

Mailing address

57 Martin Rd
Livingston, NJ 07039-4631
Phone (973) 716-0052

Other identifiers 1

IdentifierTypeStateIssuer
7190701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050331000004 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 3971559220 Receives reassigned benefits from 14 practitioners
Practice locations: West Caldwell, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

459 Passaic Ave
West Caldwell, NJ 07006-7457
Phone (973) 276-3026

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA062084NJMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pradip S. Shah, M.D. Geriatric Medicine CurrentSince Jan 1, 1990 Accepting new patients
Hospice at Lsmnj, Inc. PastSince Dec 17, 2019 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Journey HospiceEgg Harbor Township, NJ, CCN 311581 Hospice Contracted Managing Employee (40%) Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

Organizations & group practices 2

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.

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326059320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 MARTIN RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394631",
            "telephone_number": "973-716-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 PASSAIC AVE",
            "address_2": "CRANE'S MILL - OAK HEALTH CENTER",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067457",
            "telephone_number": "973-276-3026",
            "fax_number": "973-276-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRADIP",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MA062084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7190701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

Verify at the official NPI Registry.