Individual provider Active NPI

Mahrukh Shah

  • Pediatric Pulmonology Physician
  • New Haven, CT
National Provider Identifier
1346726064
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
79282 Issued in CT
Practice address
35 Park St
New Haven, CT 06519-1110
Phone
(929) 755-2963
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Pulmonology Physician 2080P0214X 79282 CT Primary

Addresses

Primary practice location

35 Park St
New Haven, CT 06519-1110

Mailing address

330 Cedar St RM 509
New Haven, CT 06510-3218
Phone (929) 755-2963

Other practice location 1

1 Brookdale Plz
Brooklyn, NY 11212-3139
Phone (718) 240-5000 ext. 5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20250805000425 CT Practitioner - Pediatric Medicine 7719495365 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Current Accepting new patients
Yale University CurrentSince Jul 17, 2025 Accepting new patients
Yale University CurrentSince Jul 17, 2025 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

35 Park St
New Haven, CT 06519
Phone (203) 200-2100

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

1 Long Wharf Dr
Ste 211
New Haven, CT 06511
Phone (203) 562-6664

330 Cedar St
Rm 509
New Haven, CT 06510

3 Shaws Cv
New London, CT 06320
Phone (860) 442-0400

1 Park St
North Haven, CT 06504
Phone (203) 785-4643

Interoperability endpoints

  • Direct secure messaging: sic9054@direct.nyp.org
  • Direct secure messaging: mshah727705@direct.ynhh.org

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1346726064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CEDAR ST RM 509",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103218",
            "telephone_number": "929-755-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191110",
            "telephone_number": "929-755-2963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brookdale Plz",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112123139",
            "country_code": "US",
            "telephone_number": "718-240-5000 x5893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MAHRUKH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CT",
            "license": "79282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.