Active NPI
Shyama Shah, NP
- Family Nurse Practitioner
- Bronx, NY
National Provider Identifier
1639744345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F347610
- Practice address
- 2015 Grand Concourse
Bronx, NY 10453-4303 - Phone
- (718) 299-7295
- Fax
- (718) 299-6797
- NPI assigned
- May 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F347610 | NY | Primary |
Addresses
Primary practice location
2015 Grand Concourse
Bronx, NY 10453-4303
Mailing address
1434 Williamsbridge Rd FL 2
Bronx, NY 10461-2507
Phone (718) 618-0401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F347610 | NY | MD | Family Nurse Practitioner |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- sshah841396@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1639744345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 WILLIAMSBRIDGE RD FL 2",
"city": "BRONX",
"state": "NY",
"postal_code": "104612507",
"telephone_number": "718-618-0401",
"fax_number": "347-479-1303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104534303",
"telephone_number": "718-299-7295",
"fax_number": "718-299-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "SHYAMA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-25",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F347610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.