Individual provider Active NPI

Suketu P Shah

  • Contractor
  • Westfield, IN
National Provider Identifier
1508144049
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
0335805-1 Issued in NY
Practice address
14902 Shelborne Rd
Westfield, IN 46074-9668
Phone
(317) 286-2885
Fax
(317) 388-0805
NPI assigned
Aug 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 0335805-1 NY Primary

Addresses

Primary practice location

14902 Shelborne Rd
Westfield, IN 46074-9668

Mailing address

14902 Shelborne Rd
Westfield, IN 46074-9668
Phone (317) 286-2885

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0335805-1NYMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1508144049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14902 SHELBORNE RD",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749668",
            "telephone_number": "317-286-2885",
            "fax_number": "317-388-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14902 SHELBORNE RD",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749668",
            "telephone_number": "317-286-2885",
            "fax_number": "317-388-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUKETU",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "0335805-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.