Individual provider Active NPI

Meenal Shukla, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1508806076
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236773 Issued in NY
Practice address
1530 Bedford Ave FL 3
Brooklyn, NY 11216-4117
Phone
(718) 400-6951
Fax
(347) 789-9300
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 236773 NY Primary

Addresses

Primary practice location

1530 Bedford Ave FL 3
Brooklyn, NY 11216-4117

Mailing address

14 Kristi Dr
Jericho, NY 11753-1309
Phone (516) 708-7008

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
I20050927001326 NY Practitioner - Internal Medicine 5991730160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1530 Bedford Ave
Brooklyn, NY 11216-4117
Phone (516) 708-7008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
236773NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Janice Prime Care Medical PC Internal Medicine CurrentSince Sep 1, 2005 Accepting new patients
Preferred Professional Medical Care PC Internal Medicine CurrentSince Aug 30, 2012 Accepting new patients
Suman Chandra Ravuri, MD Internal Medicine Past Accepting new patients

Locations

630 E 104th St
Brooklyn, NY 11236
Phone (718) 240-3100

585 Schenectady Ave
Ste D
Brooklyn, NY 11203

585 Schenectady Ave
Ste E
Brooklyn, NY 11203
Phone (416) 426-0147

1530 Bedford Ave
Fl 3
Brooklyn, NY 11216
Phone (718) 400-6951

3505 Veterans Memorial Hwy
Ste C
Ronkonkoma, NY 11779
Phone (631) 676-7556

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: mshukla@jprime.curemd.direct-ci.com

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 5

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1508806076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 KRISTI DR",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531309",
            "telephone_number": "516-708-7008",
            "fax_number": "347-464-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BEDFORD AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112164117",
            "telephone_number": "718-400-6951",
            "fax_number": "347-789-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "MEENAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.