Individual provider Active NPI

Ajay K Shah, M.D.

  • Surgery Physician
  • Bronx, NY
National Provider Identifier
1700970811
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
176519 Issued in NY
Practice address
1685 Morris Avenue
Bronx, NY 10457
Phone
(718) 960-1250
Fax
(718) 960-1230
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 176519 NY Primary

Addresses

Primary practice location

1685 Morris Avenue
Bronx, NY 10457

Mailing address

1650 Selwyn Avenue
Suite # 4-G
Bronx, NY 10457-7628
Phone (718) 960-1250

Other identifiers 1

IdentifierTypeStateIssuer
01277063MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051103000974 NY Practitioner - General Surgery 5991723389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 992-7669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Jan 1, 2004 Accepting new patients
Bronxcare Health System CurrentSince Jan 1, 2004 Accepting new patients
Bronxcare Health System Past Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

1650 Selwyn Ave
Apt 4G
Bronx, NY 10457
Phone (718) 960-1232

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
#208
Bronx, NY 10456
Phone (718) 901-8911

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ajayshah@blhc.allscriptsdirect.net

Organizations & group practices 4

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 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700970811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 SELWYN AVENUE",
            "address_2": "SUITE # 4-G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577628",
            "telephone_number": "718-960-1250",
            "fax_number": "718-960-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 MORRIS AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-960-1250",
            "fax_number": "718-960-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "176519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01277063",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.