Individual provider Active NPI

Mahendra Shah, MD

  • Anesthesiology Physician
  • Trenton, NJ
National Provider Identifier
1780690818
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
04582400 Issued in NJ
Practice address
416 Bellevue Ave
Ste 104
Trenton, NJ 08618-4513
Phone
(609) 396-4700
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 04582400 NJ Primary

Addresses

Primary practice location

416 Bellevue Ave
Ste 104
Trenton, NJ 08618-4513

Mailing address

416 Bellevue Ave
Suite 104
Trenton, NJ 08618-4513
Phone (609) 396-4700

Other identifiers 1

IdentifierTypeStateIssuer
6457401MedicaidNJ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04582400NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Family Eye Care PC PastSince May 12, 2020 Accepting new patients
Trenton Anesthesiology Associates PA Anesthesiology Past Accepting new patients

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1780690818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 BELLEVUE AVE",
            "address_2": "SUITE 104",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184513",
            "telephone_number": "609-396-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BELLEVUE AVE",
            "address_2": "STE 104",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184513",
            "telephone_number": "609-396-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MAHENDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "04582400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6457401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.