Jesal Virendra Shah, D.M.D., MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

052986-1 Issued in NY

Practice address

3915 Broadway
New York, NY 10032-1565

Phone

(212) 567-5536

Fax

(212) 202-6447

NPI assigned

Oct 22, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

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.

• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty practice Group

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Anesthesiology Physician
  • Elmhurst, NY
  • NPI 1063766038
  NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1467604363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321565",
            "telephone_number": "212-567-5536",
            "fax_number": "212-202-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321565",
            "telephone_number": "212-567-5536",
            "fax_number": "212-202-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JESAL",
        "middle_name": "VIRENDRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D., MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052986",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "052986-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalpen Shah
• Jatin P Shah, MD
• Javika Shah, PA-C
• Jeanine Caroline Shah, M.D.
• Jeel H Shah, PT
• Julie Shah
• Kamini Shah, PT
• Kanan Shah
• Kashish Piyush Shah, PT, DPT
• Kashyapkumar Shah, M.D

• Oral and Maxillofacial Surgery (Dentist) in New York, NY
• Providers in New York, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.

Verify at the official NPI Registry.