Individual provider Active NPI

Sumera Shah, MD

  • Adult Medicine Physician
  • Niagara Falls, NY
National Provider Identifier
1467770636
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
256681 Issued in NY
Practice address
621 10TH St
Niagara Falls Memorial Medical Center
Niagara Falls, NY 14301-1813
Phone
(716) 278-4000
NPI assigned
May 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 256681 NY Primary

Addresses

Primary practice location

621 10TH St
Niagara Falls Memorial Medical Center
Niagara Falls, NY 14301-1813

Mailing address

PO Box 1708
Amherst, NY 14226-7708

Other identifiers 1

IdentifierTypeStateIssuer
03236808MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000806 NY Practitioner - Family Practice 9638295496 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256681NYMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Medical Care PC CurrentSince Dec 1, 2022 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Jul 1, 2010 Accepting new patients
Wny Medical PC CurrentSince May 1, 2023 Accepting new patients
Latina Medical Office, P.C. CurrentSince Dec 1, 2022 Accepting new patients
Supportive Medical Partners, PLLC CurrentSince Apr 18, 2015 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Jul 1, 2010 Accepting new patients

Locations

188 Dahill Rd
Ste A
Brooklyn, NY 11218
Phone (646) 752-7058

4979 Harlem Rd
Buffalo, NY 14226
Phone (716) 923-4380

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

3 Upton Park
Rochester, NY 14607
Phone (585) 241-2100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

Organizations & group practices 6

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": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1467770636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1708",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142267708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "address_2": "NIAGARA FALLS MEMORIAL MEDICAL CENTER",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-278-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUMERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NY",
            "license": "256681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03236808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.