Individual provider Active NPI

Dhirajlal M Shah, MD

  • Internal Medicine Physician
  • Wurtsboro, NY
National Provider Identifier
1548241763
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
145307 Issued in NY
Practice address
2930 State Route 209
Wurtsboro, NY 12790-0207
Phone
(845) 888-2200
Fax
(845) 888-4202
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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 145307 NY Primary

Addresses

Primary practice location

2930 State Route 209
Wurtsboro, NY 12790-0207

Mailing address

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Other identifiers 1

IdentifierTypeStateIssuer
00605523MedicaidNY

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
I20060419000422 NY Practitioner - Internal Medicine 0547279598 Reassigns benefits to 1 organization
Practice locations: Wurtsboro, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians

Practice addresses (Care Compare)

111 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

60 Dunning Rd
Middletown, NY 10940-2215
Phone (845) 342-4774

75 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

95 Maltese Dr
Middletown, NY 10940-2115
Phone (845) 342-4774

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145307NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
Middletown Medical PC CurrentSince Oct 1, 2012 Accepting new patients

Locations

2142 Route 302
Circleville, NY 10919
Phone (845) 888-2200

111 Maltese Dr
Middletown, NY 10940

2930 State Route 209
Wurtsboro, NY 12790
Phone (845) 888-2200

Networks

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

Interoperability endpoints

  • Direct secure messaging: dhirajlal.shah@mmpc.eclinicaldirectplus.com

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1548241763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402115",
            "telephone_number": "845-342-4774",
            "fax_number": "845-343-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 STATE ROUTE 209",
            "city": "WURTSBORO",
            "state": "NY",
            "postal_code": "127900207",
            "telephone_number": "845-888-2200",
            "fax_number": "845-888-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHIRAJLAL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "145307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00605523",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wurtsboro, NY

Sources for this page

Verify at the official NPI Registry.