NPIMap

Individual provider Active NPI

Nimisha J Shukla, M.D.

  • Pediatrics Physician
  • Edison, NJ
National Provider Identifier
1801981386
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06753200 Issued in NJ
Practice address
1802, Oak Tree Rd.
Edison, NJ 08820-2704
Phone
(732) 548-3210
Fax
(732) 906-3966
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA06753200 NJ Primary

Addresses

Primary practice location

1802, Oak Tree Rd.
Edison, NJ 08820-2704

Mailing address

1802, Oak Tree Rd.
Edison, NJ 08820-2704
Phone (732) 548-3210

Other identifiers 5

IdentifierTypeStateIssuer
1504986OtherNJGHI
2633060OtherNJAETNA
0B1261OtherNJEMPIRE
P1637450OtherNJOXFORD PROVIDER ID#
J9447OtherNJHORIZON

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06753200NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consensus Medical Group LLC Pediatrics Past Accepting new patients
Robert Wood Johnson University Hospital, Inc Past Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
Saint Peter's University Hospital Past Accepting new patients
Nimisha Shukla, M.D., P.a. Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3487/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nimisha.shukla.1@18614.direct.athenahealth.com

Organizations & group practices 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1801981386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802, OAK TREE RD.",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202704",
            "telephone_number": "732-548-3210",
            "fax_number": "732-906-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802, OAK TREE RD.",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202704",
            "telephone_number": "732-548-3210",
            "fax_number": "732-906-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "NIMISHA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06753200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "1504986",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2633060",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "0B1261",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID#",
            "identifier": "P1637450",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "J9447",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.