Individual provider Active NPI

Jayendra Aryindlal Shah, MD

  • Physical Medicine & Rehabilitation Physician
  • Long Beach, CA
National Provider Identifier
1730354879
Registry record updated Feb 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A29575 Issued in CA
Practice address
1333 Chestnut Ave Room 205
Long Beach Comprehensive Health Center
Long Beach, CA 90813
Phone
(562) 599-8636
Fax
(562) 218-0853
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A29575 CA Primary

Addresses

Primary practice location

1333 Chestnut Ave Room 205
Long Beach Comprehensive Health Center
Long Beach, CA 90813

Mailing address

2525 E Ocean Blvd
Long Beach Comprehensive Health Center
Long Beach, CA 90803-2501
Phone (562) 599-8636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29575CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454716800000",
    "number": "1730354879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E OCEAN BLVD",
            "address_2": "LONG BEACH COMPREHENSIVE HEALTH CENTER",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032501",
            "telephone_number": "562-599-8636",
            "fax_number": "562-218-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 CHESTNUT AVE ROOM 205",
            "address_2": "LONG BEACH COMPREHENSIVE HEALTH CENTER",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90813",
            "telephone_number": "562-599-8636",
            "fax_number": "562-218-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAYENDRA",
        "middle_name": "ARYINDLAL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2016-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A29575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2016; 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.