NPIMap

Individual provider Active NPI

Samir Nalin Shah, M.D.

  • Nephrology Physician
  • Hainesport, NJ
National Provider Identifier
1659544716
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA08383300 Issued in NJ
Practice address
1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone
(856) 222-1975
Fax
(856) 222-0721
NPI assigned
Apr 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA08383300 NJ Primary

Addresses

Primary practice location

1261 Route 38
Suite a
Hainesport, NJ 08036-2702

Mailing address

1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone (856) 222-1975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000395 NJ Practitioner - Nephrology 5294806477 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Center for Kidney Care, PCGroup PAC ID 3577549666, 13 clinicians
Professional Service Fund of Deborah Heart and Lung CenterGroup PAC ID 4284537499, 118 clinicians

Practice addresses (Care Compare)

1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone (856) 222-1975

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-6611

Hospital & facility affiliations

  • DaVita Lumberton Dialysis Dialysis facility, Hainesport, NJ, CCN 312508
  • DaVita Lourdes Innova Dialysis Dialysis facility, Mount Laurel, NJ, CCN 312594
  • DaVita Willingboro Dialysis Dialysis facility, Willingboro, NJ, CCN 312584
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061
  • Deborah Heart and Lung Center Hospital, Browns Mills, NJ, CCN 310031
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08383300NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Service Fund of Deborah Heart & Lung Center CurrentSince Jun 30, 2008 Accepting new patients
The Center for Kidney Care, P.C. Nephrology CurrentSince Jul 1, 2008 Accepting new patients
Professional Service Fund of Deborah- Anesthesia Current Accepting new patients
Haddon Renal Medical Specialists, PA Nephrology Past Accepting new patients

Locations

200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200

1900 Mount Holly Rd
Ste 4
Burlington, NJ 08016

1900 Mount Holly Rd
Ste 4D
Burlington Township, NJ 08016
Phone (856) 222-1975

1261 Route 38
#A
Hainesport, NJ 08036
Phone (856) 222-1975

1542 Kuser Rd
Ste B3
Trenton, NJ 08619
Phone (609) 585-1800

Interoperability endpoints

  • Direct secure messaging: sshah35757@direct.davitaphysiciansolutions.com

Organizations & group practices 5

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 7

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1659544716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 ROUTE 38",
            "address_2": "SUITE A",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "856-222-1975",
            "fax_number": "856-222-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 ROUTE 38",
            "address_2": "SUITE A",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "856-222-1975",
            "fax_number": "856-222-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SAMIR",
        "middle_name": "NALIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08383300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

Verify at the official NPI Registry.