Bahareh Shanehsaz, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA10301200 Issued in NJ

Practice address

196 Princeton Hightstown Rd
West Windsor, NJ 08550-1672

Phone

(609) 799-5335

NPI assigned

Apr 10, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• PNP Pediatrics, LLC

  • Pediatrics Physician
  • Princeton, NJ
  • NPI 1417901521

  Single Specialty

  NPD (past)
• Somerset Pediatric Group, LLC

  • Pediatrics Physician
  • Raritan, NJ
  • NPI 1306922992

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1649666165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PRINCETON HIGHTSTOWN RD",
            "city": "WEST WINDSOR",
            "state": "NJ",
            "postal_code": "085501672",
            "telephone_number": "609-799-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PRINCETON HIGHTSTOWN RD",
            "city": "WEST WINDSOR",
            "state": "NJ",
            "postal_code": "085501672",
            "telephone_number": "609-799-5335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Rockland Rd",
            "address_2": "Suite 2B80",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033607",
            "country_code": "US",
            "telephone_number": "302-651-5874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANEHSAZ",
        "first_name": "BAHAREH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA10301200",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2858100",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://princetonnassaupediatrics.com/directory/locations/show/west-windsor-office/",
            "affiliation": "N",
            "address_1": "196 Princeton Hightstown Rd",
            "city": "West Windsor",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085501672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joanne Reiffe Fishbane, D.M.D.
• James Allen Robin, MD
• Jeffrey Stuart Rutstein, PSY.D.
• Francis S Saitoti
• Shilpa Patel Shah, M.D.
• Alka H Sheth, M.S., R.D.
• Shirom Spa & Wellness LLC
• Ajay Singh
• Mandeep Singh, DDS
• Sheila Slavick, D.M.D.

• Pediatrics Physician in West Windsor, NJ
• Providers in West Windsor, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.

Verify at the official NPI Registry.