Individual provider Active NPI

Sunil Chandra Shah, M,D

  • Otolaryngic Allergy Physician
  • Paterson, NJ
National Provider Identifier
1497792121
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
29587 Issued in NJ
Practice address
52 13TH Ave
Paterson, NJ 07504-1544
Phone
(073) 278-9023
Fax
(973) 977-6761
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X 29587 NJ Primary

Addresses

Primary practice location

52 13TH Ave
Paterson, NJ 07504-1544

Mailing address

16 Gathering Road
Pinebrook, NJ 07058
Phone (973) 278-9023

Other identifiers 1

IdentifierTypeStateIssuer
2945509MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2958NJMDPsychologist
29587NJMDOtolaryngic Allergy Physician

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497792121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GATHERING ROAD",
            "city": "PINEBROOK",
            "state": "NJ",
            "postal_code": "07058",
            "telephone_number": "973-278-9023",
            "fax_number": "973-977-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 13TH AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041544",
            "telephone_number": "073-278-9023",
            "fax_number": "973-977-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUNIL",
        "middle_name": "CHANDRA",
        "name_prefix": "Dr.",
        "credential": "M,D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NJ",
            "license": "29587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2945509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.