Individual provider Active NPI

Kreena Shah, MD

  • Family Medicine Physician
  • Deptford, NJ
National Provider Identifier
1518546241
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12089700 Issued in NJ
Practice address
1450 Almonesson Rd Ste 225
Deptford, NJ 08096-5241
Phone
(856) 227-8611
Fax
(856) 227-5716
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA12089700 NJ Primary

Addresses

Primary practice location

1450 Almonesson Rd Ste 225
Deptford, NJ 08096-5241

Mailing address

134 Bridgeton Pike Ste C
Mullica Hill, NJ 08062-2616
Phone (856) 507-2783

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031001704 NJ Practitioner - Family Practice 6002349834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

798 Centerton Rd
Pittsgrove, NJ 08318-3945
Phone (856) 358-6161

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. CurrentSince Nov 18, 2024 Accepting new patients

Locations

1450 Almonesson Rd
Ste 225
Deptford, NJ 08096
Phone (856) 227-8611

134 Bridgeton Pike
Ste C
Mullica Hill, NJ 08062
Phone (856) 478-2111

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

Organizations & group practices 1

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1518546241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BRIDGETON PIKE STE C",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622616",
            "telephone_number": "856-507-2783",
            "fax_number": "856-221-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 ALMONESSON RD STE 225",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080965241",
            "telephone_number": "856-227-8611",
            "fax_number": "856-227-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KREENA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12089700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deptford, NJ

Sources for this page

Verify at the official NPI Registry.