Individual provider Active NPI

Svetlana Claravall Shah, MD

  • Family Medicine Physician
  • Fort Drum, NY
National Provider Identifier
1477696193
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
268281 Issued in NY
Practice address
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Phone
(315) 772-2778
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 268281 NY Primary
Family Medicine Physician 207Q00000X 24607 OK

Addresses

Primary practice location

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Mailing address

22220 Riverglade Dr
Watertown, NY 13601-1773
Phone (405) 517-2478

Other practice location 1

900 NE 1
FMC 2102
Oklahoma City, OK 73104-5420
Phone (405) 271-2230

Other identifiers 1

IdentifierTypeStateIssuer
03919000MedicaidNY

Other names 1

  • Svetlana Claravall Lazaro Former name

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
I20110310000084 NY Practitioner - Family Practice 2264614403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1233 Arsenal St
Watertown, NY 13601-2213
Phone (315) 221-5289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24607OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Mar 1, 2021 Accepting new patients

Locations

1438 Western Ave
Albany, NY 12203
Phone (518) 542-1393

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

1233 Arsenal St
Watertown, NY 13601
Phone (315) 221-5289

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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477696193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22220 RIVERGLADE DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011773",
            "telephone_number": "405-517-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 NE 1",
            "address_2": "FMC 2102",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045420",
            "country_code": "US",
            "telephone_number": "405-271-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SVETLANA",
        "middle_name": "CLARAVALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "268281",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "24607",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03919000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SVETLANA",
            "last_name": "LAZARO",
            "middle_name": "CLARAVALL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.