Active NPI
Kiran Damodar Shah, M.D
- Allergy & Immunology Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 165396
- Practice address
- 1901 1St Ave
Department of Pediatrics
New York, NY 10029-7404 - Phone
- (212) 423-6228
- NPI assigned
- Nov 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 165396 | NY | Primary |
Addresses
Primary practice location
1901 1St Ave
Department of Pediatrics
New York, NY 10029-7404
Mailing address
6 Saratoga CT
Nanuet, NY 10954-3112
Phone (845) 627-7032
Other practice location 1
234 E 149th St
Bronx, NY 10451-5504
Phone (718) 579-5000
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downtown Bronx Medical Associates PC | Current | Accepting new patients | |
| Physician Affiliate Group of New York PC | Current | Accepting new patients | |
| Metropolitan Medical Practice Plan PC | Current | Accepting new patients | |
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Locations
234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
1901 1st Ave
New York, NY 10029
Phone (212) 230-6262
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- kshah839186@nychhc.direct-ci.com
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
-
- General Practice Physician
- New York, NY
- NPI 1306138383
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1801967963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 SARATOGA CT",
"city": "NANUET",
"state": "NY",
"postal_code": "109543112",
"telephone_number": "845-627-7032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 1ST AVE",
"address_2": "DEPARTMENT OF PEDIATRICS",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100297404",
"telephone_number": "212-423-6228"
}
],
"practiceLocations": [
{
"address_1": "234 E 149th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104515504",
"country_code": "US",
"telephone_number": "718-579-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAH",
"first_name": "KIRAN",
"middle_name": "DAMODAR",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-12",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NY",
"license": "165396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.