Individual provider Active NPI

Tara Shah, M.D.

  • Interventional Cardiology Physician
  • Flushing, NY
National Provider Identifier
1558660779
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
280056 Issued in NY
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 670-1651
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C1-0013238 DE
Cardiovascular Disease Physician 207RC0000X 280056 NY
Interventional Cardiology Physician 207RI0011X C1-0013238 DE
Interventional Cardiology Physician 207RI0011X 280056 NY Primary

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

200 Hygeia Dr Ste 2300
Newark, DE 19713-2049

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL FHIR Health Information Exchange (HIE)
Direct Messaging Address tas2012@med.cornell.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190918002946 DE Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5597095471 Reassigns benefits to 1 organization
I20201209001940 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5597095471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Aug 28, 2019 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 16, 2020 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 16, 2020 Accepting new patients
Christiana Care Health Services, Inc Cardiovascular Disease CurrentSince Aug 28, 2019 Accepting new patients
Newyork-Presbyterian-Queens Past Accepting new patients

Locations

200 Hygeia Dr
Ste 1360
Newark, DE 19713
Phone (302) 320-9440

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

3521 Silverside Rd
Ste 1C
Wilmington, DE 19810
Phone (302) 368-3007

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

11205 Queens Blvd
Ste A
Forest Hills, NY 11375
Phone (347) 480-1200

11205 Queens Blvd
Forest Hills, NY 11375
Phone (718) 732-1550

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

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

Interoperability endpoints

  • Direct secure messaging: tas2012@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 4

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1558660779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "DE",
            "license": "C1-0013238",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "280056",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "DE",
            "license": "C1-0013238",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "280056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "FHIR",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tas2012@med.cornell.edu",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct address",
            "address_1": "11205 Queens Blvd Ste A",
            "city": "Forest Hills",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113758311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.