Individual provider Active NPI

Shani Shah, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1578182176
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045474 Issued in NY
Practice address
535 Flushing Ave
Brooklyn, NY 11205-1610
Phone
(718) 488-7272
NPI assigned
Apr 13, 2020
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 045474 NY Primary

Addresses

Primary practice location

535 Flushing Ave
Brooklyn, NY 11205-1610

Mailing address

535 Flushing Ave
Brooklyn, NY 11205-1610
Phone (718) 488-7272

Other identifiers 1

IdentifierTypeStateIssuer
045747OtherNYREGISTRATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200430000229 NY Practitioner - Physical Therapist in Private Practice 1951731165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Road to Recovery Physical Therapy, P.C.Group PAC ID 8022295096, 22 clinicians

Practice addresses (Care Compare)

535 Flushing Ave
Brooklyn, NY 11205-1610
Phone (781) 488-7272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045474NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Road to Recovery Physical Therapy, P.C. Physical Therapist CurrentSince Apr 1, 2020 Accepting new patients

Locations

535 Flushing Ave
Brooklyn, NY 11205
Phone (781) 488-7272

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1578182176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 FLUSHING AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051610",
            "telephone_number": "718-488-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 FLUSHING AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051610",
            "telephone_number": "718-488-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHANI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRATION",
            "identifier": "045747",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.