Individual provider Active NPI

Shalva Eliava, MD

  • Hospitalist Physician
  • Kansas City, KS
National Provider Identifier
1417696345
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
04-53153 Issued in KS
Practice address
4000 Cambridge St
Kansas City, KS 66160-8501
Phone
(913) 588-1227
NPI assigned
May 31, 2022
Reactivated
Mar 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04-53153 KS
Hospitalist Physician 208M00000X 04-53153 KS Primary

Addresses

Primary practice location

4000 Cambridge St
Kansas City, KS 66160-8501

Mailing address

350 Engle Street, Department of Medicine
Englewood, NJ 07631
Phone (201) 894-3143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250712000122 NJ Practitioner - Internal Medicine 9638684368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 292-1400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Multi-Specialty CurrentSince Jul 1, 2025 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Organizations & group practices 1

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.

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": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1417696345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ENGLE STREET, DEPARTMENT OF MEDICINE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-894-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608501",
            "telephone_number": "913-588-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAVA",
        "first_name": "SHALVA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "deactivation_date": "2023-02-27",
        "reactivation_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-53153",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "04-53153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.