Mahendra K. Shah, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD038467L Issued in PA

Practice address

2872 Turnpike St
Susquehanna, PA 18847-2771

Phone

(570) 853-3135

Fax

(570) 853-3008

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1700820180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25066 SR 11",
            "address_2": "NEPA COMMUNITY HEALTH CARE",
            "city": "HALLSTEAD",
            "state": "PA",
            "postal_code": "18822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2872 TURNPIKE ST",
            "city": "SUSQUEHANNA",
            "state": "PA",
            "postal_code": "188472771",
            "telephone_number": "570-853-3135",
            "fax_number": "570-853-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MAHENDRA",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD038467L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00637967",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reddon Drug Co. Inc.
• Reddon Pharmacy
• Kathleen Reddon, PHARMACIS
• Julie Aileen Rowe, L.AC
• Jesse Santarelli, BS, PTA
• Margaret Smith, MS CRNP
• Brandea R Sparks, AGPCNP
• Nicole Ann Suhadolnik, FNP-C
• Susquehanna Community School District
• Susquehanna Family Pharmacy LLC

• Internal Medicine Physician in Susquehanna, PA
• Providers in Susquehanna, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.