Individual provider Active NPI

Nikit Y Shah, PA-C

  • Medical Physician Assistant
  • North Haven, CT
National Provider Identifier
1487904520
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002815 Issued in CT
Practice address
52 Washington Ave
Suite 4
North Haven, CT 06473-1724
Phone
(203) 672-2800
NPI assigned
Sep 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002815 CT Primary

Addresses

Primary practice location

52 Washington Ave
Suite 4
North Haven, CT 06473-1724

Mailing address

52 Washington Ave
Suite 4
North Haven, CT 06473-1724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181004002656 NC Practitioner - Physician Assistant 1153572763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke University Affiliated Physicians, Inc.Group PAC ID 3779489588, 452 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

100 Duke Health Cary PL
Suite 110
Cary, NC 27519-6760
Phone (919) 385-4855

1901 Hillandale Rd
Durham, NC 27705-2664

2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818

351 Wellesley Trade LN
Suite 100
Cary, NC 27519-5669
Phone (919) 576-8100

7200 Creedmoor Rd
Suite 208
Raleigh, NC 27613-1711
Phone (919) 327-1650

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002815CTMDClinical Child & Adolescent Psychologist
2815CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc Internal Medicine CurrentSince Sep 10, 2018 Accepting new patients
Duke University Affiliated Physicians, Inc. Internal Medicine CurrentSince Sep 10, 2018 Accepting new patients

Locations

351 Wellesley Trade Ln
Ste 100
Cary, NC 27519
Phone (919) 576-8100

5716 Fayetteville Rd
Durham, NC 27713
Phone (919) 572-1862

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

7021 Harps Mill Rd
Ste 100
Raleigh, NC 27615
Phone (919) 576-8480

7021 Harps Mill Rd
Raleigh, NC 27615
Phone (919) 823-5446

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Organizations & group practices 3

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 8

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": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1487904520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 WASHINGTON AVE",
            "address_2": "SUITE 4",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 WASHINGTON AVE",
            "address_2": "SUITE 4",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731724",
            "telephone_number": "203-672-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NIKIT",
        "middle_name": "Y",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "002815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

Verify at the official NPI Registry.