Shoba Menon MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SHOBA MENON MD, PC

Practice address

1866 Wading River Manor Rd
Wading River, NY 11792-2137

Phone

(631) 929-8787

Fax

(631) 929-0350

NPI assigned

Jan 5, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Shoba Menon, M.D.

Title

Physician

Phone

(631) 929-8787

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahendra G. Shah, M.D.

  • Family Medicine Physician
  • Wading River, NY
  • NPI 1215020011
  NPD (past)

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1659816213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 625",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922137",
            "telephone_number": "631-929-8787",
            "fax_number": "631-929-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 WADING RIVER MANOR RD",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922137",
            "telephone_number": "631-929-8787",
            "fax_number": "631-929-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOBA MENON MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "MENON",
        "authorized_official_first_name": "SHOBA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-929-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oliverto Marshall Senobe
• Rachael Sereno
• Cheryl Shaffer, NP
• Mahendra G. Shah, M.D.
• John Joseph Sheppard, PA-C
• Megan Ann Simon, LCSW
• Liron Sinn
• Katharine Smith, M.S.CCC-SLP
• Melissa Ann Smith, LMSW
• Raegan M Smith, RN

• Internal Medicine Physician in Wading River, NY
• Providers in Wading River, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.