Organization Active NPI

D.K Shah MD PC

Doing business as Grand Street Medical Associates

  • Endocrinology, Diabetes & Metabolism Physician
  • Kingston, NY
National Provider Identifier
1659626489
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
252903-1 Issued in NY
Legal business name
D.K SHAH MD PC
Doing business as
Grand Street Medical Associates
Practice address
368 Broadway
Medical Arts Building , Suite301
Kingston, NY 12401-5144
Phone
(845) 338-1535
Fax
(845) 338-9879
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Authorized official

Name
Mr. Amjad Khan
Title
Billing Manager
Phone
(845) 338-1535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 252903-1 NY Primary

Addresses

Primary practice location

368 Broadway
Medical Arts Building , Suite301
Kingston, NY 12401-5144

Mailing address

368 Broadway
Medical Arts Building , Suite301
Kingston, NY 12401-5144
Phone (845) 338-1535

Other names 1

  • GRAND STREET MEDICAL ASSOCIATES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DK Shah MD PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

368 Broadway
Ste 301
Kingston, NY 12401
Phone (845) 338-1535

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1659626489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 BROADWAY",
            "address_2": "MEDICAL ARTS BUILDING , SUITE301",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015144",
            "telephone_number": "845-338-1535",
            "fax_number": "845-338-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 BROADWAY",
            "address_2": "MEDICAL ARTS BUILDING , SUITE301",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015144",
            "telephone_number": "845-338-1535",
            "fax_number": "845-338-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.K SHAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AMJAD",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "845-338-1535",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "252903-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAND STREET MEDICAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.