Active NPI
Jitendra Chimanlal Shah, M.D.
- Pulmonary Disease Physician
- Brooklyn, NY
National Provider Identifier
1386797165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 138990
- Practice address
- 8502 Fort Hamilton Pkwy
Brooklyn, NY 11209-4865 - Phone
- (917) 748-2299
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 138990 | NY | Primary |
Addresses
Primary practice location
8502 Fort Hamilton Pkwy
Brooklyn, NY 11209-4865
Mailing address
6 Holsman Rd
Staten Island, NY 10301-4427
Phone (917) 748-2299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138990 | NY | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of New York Office of Payroll Administration | Past | Accepting new patients | |
| City of New York Office of Payroll Administration | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba NYC DOHMH Crown Heights HC
- State or Local Public Health Clinic/Center
- Brooklyn, NY
- NPI 1679501647
-
dba NYCDOHMH Bushwick District
- Community Health Clinic/Center
- Brooklyn, NY
- NPI 1912953035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386797165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 HOLSMAN RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103014427",
"telephone_number": "917-748-2299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8502 FORT HAMILTON PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112094865",
"telephone_number": "917-748-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "JITENDRA",
"middle_name": "CHIMANLAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "138990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.