Individual provider Active NPI

Suraj Shah, DO

  • Hospitalist Physician
  • Ridgewood, NJ
National Provider Identifier
1336638071
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
311832 Issued in NY
Practice address
1200 E Ridgewood Ave Ste 303
Ridgewood, NJ 07450-3937
Phone
(201) 689-7755
Fax
(201) 689-0521
NPI assigned
May 8, 2018
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 25MB12586600 NJ
Hospitalist Physician 208M00000X 311832 NY Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MB12586600 NJ

Addresses

Primary practice location

1200 E Ridgewood Ave Ste 303
Ridgewood, NJ 07450-3937

Mailing address

1200 E Ridgewood Ave Ste 303
Ridgewood, NJ 07450-3937
Phone (201) 689-7755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210922002961 NY Practitioner - Hospitalist 1456697994 Reassigns benefits to 1 organization
I20250910000331 NJ Practitioner - Pulmonary Disease 1456697994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Rowan University School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311832NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Aug 1, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2021 Accepting new patients
Johnson Upper Extremity OT Services, PC Past Accepting new patients

Locations

1200 E Ridgewood Ave
Ste 303
Ridgewood, NJ 07450
Phone (201) 689-7755

1000 10th Ave
Fl 3
New York, NY 10019
Phone (212) 241-2299

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

1000 10th Ave
Ste 3A2
New York, NY 10019
Phone (212) 259-6777

Interoperability endpoints

  • Direct secure messaging: suraj.shah.1@5622.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1336638071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E RIDGEWOOD AVE STE 303",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503937",
            "telephone_number": "201-689-7755",
            "fax_number": "201-689-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E RIDGEWOOD AVE STE 303",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503937",
            "telephone_number": "201-689-7755",
            "fax_number": "201-689-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SURAJ",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB12586600",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "311832",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MB12586600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.