NPIMap

Individual provider Active NPI

Dhiren Ashwinbhai Shah, MD

  • Internal Medicine Physician
  • Brick, NJ
National Provider Identifier
1548627102
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA09868700 Issued in NJ
Practice address
425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone
(732) 836-4817
NPI assigned
Jan 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 25MA09868700 NJ Primary

Addresses

Primary practice location

425 Jack Martin Blvd
Brick, NJ 08724-7732

Mailing address

425 Jack Martin Blvd.
Brick, NJ 08724
Phone (732) 836-4817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915000183 NJ Practitioner - Internal Medicine 9638465834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plover Inpatient Services LLCGroup PAC ID 1355561663, 158 clinicians

Practice addresses (Care Compare)

1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
26.17 of 100Reported as individual
Quality
30
Improvement activities
0
Cost
15.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HMH Hospitals Corporation Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1548627102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD.",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-836-4817",
            "fax_number": "732-836-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-836-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHIREN",
        "middle_name": "ASHWINBHAI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09868700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.