Individual provider Active NPI

Krupa Shah, M.D.

  • Family Medicine Physician
  • Rochester, NY
National Provider Identifier
1609978253
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6551483 Issued in NY
Practice address
1000 South Ave # 58
Rochester, NY 14620-2733
Phone
(585) 341-6779
NPI assigned
Sep 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2006014589 MO
Family Medicine Physician 207Q00000X 6551483 NY Primary

Addresses

Primary practice location

1000 South Ave # 58
Rochester, NY 14620-2733

Mailing address

1000 South Ave # 58
Rochester, NY 14620-2733
Phone (585) 341-6779

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
I20090126000549 NY Practitioner - Family PracticePractitioner - Geriatric MedicinePractitioner - Internal Medicine 6103980768 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Anns Home for the AgedGroup PAC ID 5092758938, 11 clinicians

Practice addresses (Care Compare)

1500 Portland Ave
Rochester, NY 14621-3065
Phone (585) 342-1700

Hospital & facility affiliations

  • Rochester Regional Health Hospice Care Hospice, Rochester, NY, CCN 331506
  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • St. Ann's Community Nursing home, Rochester, NY, CCN 335081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6551483NYMDFamily Medicine Physician
2006014589MOMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Ann'S Home for the Aged CurrentSince Jan 1, 2019 Accepting new patients
St. Ann'S Nursing Home Company, Inc CurrentSince Jan 1, 2019 Accepting new patients
St Anns Home for the Aged CurrentSince Jan 1, 2019 Accepting new patients
Highland Hospital of Rochester Current Accepting new patients
Highland Hospital of Rochester CurrentSince Jan 5, 2009 Accepting new patients
Highland Hospital of Rochester CurrentSince Jan 5, 2009 Accepting new patients

Locations

601 Elmwood Ave
#320
Rochester, NY 14642

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

601 Elmwood Ave
#665
Rochester, NY 14642
Phone (585) 275-5168

1000 South Ave
#58
Rochester, NY 14620
Phone (585) 341-6776

920 Cherry Ridge Blvd
Webster, NY 14580
Phone (585) 697-6337

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": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1609978253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE # 58",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-341-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SOUTH AVE # 58",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146202733",
            "telephone_number": "585-341-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KRUPA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2006014589",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "6551483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.