Surendralal G. Shah, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

133617 Issued in NY

Practice address

528 Old Country Road
Plainview, NY 11803-4997

Phone

(516) 822-4706

Fax

(516) 822-1373

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: surendrashah@smgl.allscriptsdirect.net

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.

• Atm Yousuf Physician PC

  • Internal Medicine Physician
  • Westbury, NY
  • NPI 1992829824
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1558445973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 OLD COUNTRY ROAD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034997",
            "telephone_number": "516-822-4706",
            "fax_number": "516-822-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 OLD COUNTRY ROAD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034997",
            "telephone_number": "516-822-4706",
            "fax_number": "516-822-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SURENDRALAL",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "133617",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "133617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00725493",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shah Medical Group LLP
• Kandrap Yashvant Shah, PTA
• Mrudula S. Shah, MD
• Nikita Shah, MD
• Parth Vinit Shah, M.D.
• Rebecca Shamash
• Kanza Shamim, MD
• Ahmad Shamulzai, MD
• Amy Shapiro-Rosenbaum, PH.D.
• Jennifer Rose Shapiro, M.S. CCC/SLP

• Nephrology Physician in Plainview, NY
• Providers in Plainview, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.