Individual provider Active NPI

Trisha Shah, M.D.

  • Reproductive Endocrinology Physician
  • Coral Gables, FL
National Provider Identifier
1558788935
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
ME148605 Issued in FL
Practice address
4425 Ponce de Leon Blvd Ste 110
Coral Gables, FL 33146-1842
Phone
(305) 446-4673
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VE0102X ME148605 FL Primary

Addresses

Primary practice location

4425 Ponce de Leon Blvd Ste 110
Coral Gables, FL 33146-1842

Mailing address

4425 Ponce de Leon Blvd Ste 110
Coral Gables, FL 33146-1842
Phone (305) 446-4673

Other names 1

  • Trisha Kadakia Former name

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
I20180817000579 NY Practitioner - Obstetrics/Gynecology 6204185663 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME148605FLMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 27, 2018 Accepting new patients
Montefiore Medical Center Single Specialty CurrentSince Jun 27, 2018 Accepting new patients
Vitalmd Group Holding LLC Single Specialty Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

141 S Central Ave
Ste 201
Hartsdale, NY 10530
Phone (914) 997-1060

Interoperability endpoints

  • Direct secure messaging: shah.trisha.013.0090450@cofl.meditab.direct-ci.com

Organizations & group practices 3

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1558788935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 PONCE DE LEON BLVD STE 110",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461842",
            "telephone_number": "305-446-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 PONCE DE LEON BLVD STE 110",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461842",
            "telephone_number": "305-446-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "TRISHA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME148605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISHA",
            "last_name": "KADAKIA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.