Individual provider Active NPI

Sheena Shah, PA-C

  • Medical Physician Assistant
  • East Hanover, NJ
National Provider Identifier
1548711690
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00413800 Issued in NJ
Practice address
383 Ridgedale Ave
East Hanover, NJ 07936-1445
Phone
(973) 887-0200
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00413800 NJ Primary

Addresses

Primary practice location

383 Ridgedale Ave
East Hanover, NJ 07936-1445

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170516000227 NJ Practitioner - Physician Assistant 5193002459 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians
RT Bock MD Consultancy, LLCGroup PAC ID 4183646151, 6 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

91 Union Valley Rd
Newfoundland, NJ 07435-1603
Phone (201) 492-4987

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00413800NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Dec 1, 2025 Accepting new patients
Summit Medical Group PA CurrentSince Dec 1, 2025 Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

Interoperability endpoints

  • Direct secure messaging: sheena.shah.1@2983.direct.athenahealth.com

Organizations & group practices 6

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 1

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": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1548711690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 RIDGEDALE AVE",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079361445",
            "telephone_number": "973-887-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00413800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hanover, NJ

Sources for this page

Verify at the official NPI Registry.