Active NPI
Hetal S Shah, M.D.
- Family Medicine Physician
- Marlton, NJ
National Provider Identifier
1497784094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25MA07503100
- Practice address
- 777 Route 70 East
Sutie G-101
Marlton, NJ 08053-2345 - Phone
- (856) 983-9939
- Fax
- (856) 983-9936
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MA075031 | NJ | |
| Family Medicine Physician | 207Q00000X | 25MA07503100 | NJ | Primary |
Addresses
Primary practice location
777 Route 70 East
Sutie G-101
Marlton, NJ 08053-2345
Mailing address
777 Route 70 East
Suite G-101
Marlton, NJ 08053-2345
Phone (856) 983-9939
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240537 | Other | NJ | AMERIGROUP |
| 7876554 | Other | NJ | AETNA |
| 0045047 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wright State University Boonshoft School of Medicine, 2000
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1529 Route 206
Suite L
Tabernacle, NJ 08088-8801
Phone (609) 268-0707
777 Route 70 E
Suite G101
Marlton, NJ 08053-2548
Phone (856) 983-9939
Hospital & facility affiliations
- Virtua Home Care at West Jersey
- Cooper University Hospital
- West Jersey Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA075031 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elmwood Family Physicians | Family Medicine | Current | Accepting new patients |
| Tabernacle Family Physicians LLC | Current | Accepting new patients |
Locations
777 Route 70 E
Ste G101
Marlton, NJ 08053
Phone (856) 818-4020
1529 Route 206
Ste L
Tabernacle, NJ 08088
Phone (609) 268-0707
Interoperability endpoints
- hetal.shah@efp.directbygreenway.com
- hetal.shah@tfp.directbygreenway.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Marlton, NJ
- NPI 1578640538
-
- Health Service Clinic/Center
- Tabernacle, NJ
- NPI 1437203874
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Camden, NJ
- NPI 1568442309
-
- Home Health Agency
- Marlton, NJ
- NPI 1316943004
-
- General Acute Care Hospital
- Voorhees, NJ
- NPI 1528064409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416873600000",
"number": "1497784094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 ROUTE 70 EAST",
"address_2": "SUITE G-101",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080532345",
"telephone_number": "856-983-9939",
"fax_number": "856-983-9936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 ROUTE 70 EAST",
"address_2": "SUTIE G-101",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080532345",
"telephone_number": "856-983-9939",
"fax_number": "856-983-9936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "HETAL",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2014-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "MA075031",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "25MA07503100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "240537",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7876554",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0045047",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.