Individual provider Active NPI

Nirav Shah, PT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1699860767
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026046-1 Issued in NY
Practice address
3249 Francis Lewis Blvd
Flushing, NY 11358-1923
Phone
(718) 224-3818
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 026046-1 NY Primary

Addresses

Primary practice location

3249 Francis Lewis Blvd
Flushing, NY 11358-1923

Mailing address

80 I U Willets Rd
Roslyn, NY 11576-3038
Phone (516) 270-5527

Other identifiers 1

IdentifierTypeStateIssuer
03169660MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050806000070 NY Practitioner - Physical Therapist in Private Practice 9931138393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Age Physical Therapy PCGroup PAC ID 9032138516, 2 clinicians

Practice addresses (Care Compare)

3249 Francis Lewis Blvd
Flushing, NY 11358-1923
Phone (718) 224-3818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026046-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Age Physical Therapy PC CurrentSince Apr 30, 2003 Accepting new patients
Lombardi & Silver LLP PastSince Sep 1, 2006 Accepting new patients

Locations

3249 Francis Lewis Blvd
Flushing, NY 11358
Phone (718) 224-3818

3207 Francis Lewis Blvd
Flushing, NY 11358
Phone (718) 224-2030

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1699860767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 I U WILLETS RD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763038",
            "telephone_number": "516-270-5527",
            "fax_number": "516-908-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 FRANCIS LEWIS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581923",
            "telephone_number": "718-224-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NIRAV",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026046-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03169660",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.