Sandeep A Shah

Primary specialty

PharmacistTaxonomy code 183500000X

License

045193 Issued in NY

Practice address

399 Route 112
Patchogue, NY 11772-1849

Phone

(631) 758-2154

NPI assigned

Feb 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• SMS1 Pharmacy Corp

  • Community/Retail Pharmacy
  • Wyandanch, NY
  • NPI 1326559048
  NPD Authorized official
• Pathmark Stores Inc

  • Pharmacy
  • Staten Island, NY
  • NPI 1558461590
  NPD (past)
• Pathmark Stores Inc

  • Pharmacy
  • Patchogue, NY
  • NPI 1780781542
  NPD (past)

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1417125667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 AUDLEY CT",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117264407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 ROUTE 112",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721849",
            "telephone_number": "631-758-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SANDEEP",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "045193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH STATE LICENSE NUMBER",
            "identifier": "041593",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Diana Sgro, DPM
• Brian Shadbolt, PHARMD
• Girish J Shah, DDS
• Jitendra A Shah, M.D.
• Panna Shah, M.D.
• Vijay Shah, MD
• Shahin Firoz Shaikh, MD
• Anthony J Shallash, MD
• David Lee Shapiro, D.C.
• Aman Sharma

• Pharmacist in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.