Individual provider Active NPI

Mona Shah, MD

  • Pediatrics Physician
  • Albuquerque, NM
National Provider Identifier
1528107539
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2004-0431 Issued in NM
Practice address
1401 William Street SE
Albuquerque, NM 87102
Phone
(505) 768-5450
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2004-0431 NM Primary

Addresses

Primary practice location

1401 William Street SE
Albuquerque, NM 87102

Mailing address

1401 William Street SE
Albuquerque, NM 87102
Phone (505) 768-5450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20071101000255 NM Practitioner - Pediatric MedicinePractitioner - Family Practice 8123115516 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004-0431NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Community Healthcare, Inc. Current Accepting new patients
First Choice Community Healthcare, Inc. CurrentSince Mar 12, 2021 Accepting new patients

Locations

1401 William St SE
Albuquerque, NM 87102
Phone (505) 768-5450

2001 El Centro Familiar Blvd SW
Albuquerque, NM 87105
Phone (505) 873-7462

145 Don Pasqual Rd NW
Los Lunas, NM 87031
Phone (505) 224-8740

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1528107539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 WILLIAM STREET SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87102",
            "telephone_number": "505-768-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WILLIAM STREET SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87102",
            "telephone_number": "505-768-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MONA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "2004-0431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.