Active NPI
Shella Kumar Mongia, MBBS, MD
- Molecular Genetic Pathology (Pathology) Physician
- Roslyn, NY
National Provider Identifier
1447458997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Molecular Genetic Pathology (Pathology) Physician
- License
- ME 110585
- Practice address
- 381 Elm Dr
Roslyn, NY 11576-3045 - Phone
- (917) 476-5173
- NPI assigned
- Jul 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | 1020797 | MA | |
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | ME 110585 | FL | Primary |
Addresses
Primary practice location
381 Elm Dr
Roslyn, NY 11576-3045
Mailing address
381 Elm Dr
Roslyn, NY 11576-3045
Phone (917) 476-5173
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, GA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 110585 | FL | MD | Molecular Genetic Pathology (Pathology) Physician |
| 1020797 | MA | MD | Molecular Genetic Pathology (Pathology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Conemaugh Physician Practices LLC | Current | Accepting new patients | |
| DLP Conemaugh Physician Practices LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| DLP Conemaugh Physician Practices LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Cresson, PA
- NPI 1932515905
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Family Medicine Physician
- Nanty Glo, PA
- NPI 1003222134
-
- Internal Medicine Physician
- Johnstown, PA
- NPI 1205242609
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734048000000",
"number": "1447458997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "381 ELM DR",
"city": "ROSLYN",
"state": "NY",
"postal_code": "115763045",
"telephone_number": "917-476-5173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 ELM DR",
"city": "ROSLYN",
"state": "NY",
"postal_code": "115763045",
"telephone_number": "917-476-5173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONGIA",
"first_name": "SHELLA",
"middle_name": "KUMAR",
"credential": "MBBS, MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-06",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "MA",
"license": "1020797",
"primary": false
},
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "FL",
"license": "ME 110585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roslyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.