Individual provider Active NPI

Shounak Shah, PT, DPT

  • Physical Therapist
  • Hoboken, NJ
National Provider Identifier
1407191448
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA1474000 Issued in NJ
Practice address
1115 Grand St Apt 5B
Hoboken, NJ 07030-2260
Phone
(201) 893-7424
NPI assigned
Dec 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA1474000 NJ Primary

Addresses

Primary practice location

1115 Grand St Apt 5B
Hoboken, NJ 07030-2260

Mailing address

1115 Grand St Apt 5B
Hoboken, NJ 07030-2260
Phone (201) 893-7424

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA1474000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shah Rehabilitation Group LLC CurrentSince Aug 23, 2020 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist Past Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients
Sportscare of America, PC Physical Therapist PastSince Jan 10, 2007 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1407191448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 GRAND ST APT 5B",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302260",
            "telephone_number": "201-893-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 GRAND ST APT 5B",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302260",
            "telephone_number": "201-893-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHOUNAK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-03",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA1474000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.