Individual provider Active NPI

Nirali Shah Jain

  • Reproductive Endocrinology Physician
  • Basking Ridge, NJ
National Provider Identifier
1497146039
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
25MA12132600 Issued in NJ
Practice address
140 Allen Rd
Basking Ridge, NJ 07920-2976
Phone
(908) 604-7800
NPI assigned
Feb 17, 2015
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 25MA12132600 NJ Primary

Addresses

Primary practice location

140 Allen Rd
Basking Ridge, NJ 07920-2976

Mailing address

30 Bellavista CT
Edison, NJ 08820-4439

Other identifiers 1

IdentifierTypeStateIssuer
13-3971298MedicaidNY

Other names 1

  • Nirali Shah 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
I20190129003264 NY Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 5597002592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MA12132600NJMDReproductive Endocrinology Physician

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1497146039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BELLAVISTA CT",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088204439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ALLEN RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202976",
            "telephone_number": "908-604-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "NIRALI",
        "middle_name": "SHAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NJ",
            "license": "25MA12132600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13-3971298",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIRALI",
            "last_name": "SHAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Basking Ridge, NJ

Sources for this page

Verify at the official NPI Registry.