Individual provider Active NPI

Pooja Shah, DPM

  • Foot & Ankle Surgery Podiatrist
  • New Hyde Park, NY
National Provider Identifier
1821520933
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N007085-01 Issued in NY
Practice address
3003 New Hyde Park Rd Ste 312
New Hyde Park, NY 11042-1214
Phone
(516) 492-3515
NPI assigned
Mar 28, 2017
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N007085-01 NY Primary

Addresses

Primary practice location

3003 New Hyde Park Rd Ste 312
New Hyde Park, NY 11042-1214

Mailing address

3003 New Hyde Park Rd
Ste 312
New Hyde Park, NY 11042-1214
Phone (516) 492-3515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829004146 NJ Practitioner - Podiatry 1951725910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Foot and Ankle PAGroup PAC ID 7315950268, 7 clinicians

Practice addresses (Care Compare)

528 Boulevard
Keilworth, NJ 07033-1657
Phone (908) 276-6624

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue22
Removal of skin lesions14
Removal of nail tissue696
Removal or shaving of skin growth358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N007085-01NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Foot and Ankle, P.a. Foot & Ankle Surgery CurrentSince Aug 29, 2024 Accepting new patients
LGD Podiatric Surgical, PC Foot & Ankle Surgery CurrentSince Jul 1, 2020 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Dec 28, 2021 Accepting new patients
Essen Medical Associates, PC CurrentSince Dec 28, 2021 Accepting new patients
Shakespeare Operating LLC CurrentSince Jan 1, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Dec 28, 2021 Accepting new patients
West Village Podiatric Surgical PC Foot & Ankle Surgery CurrentSince Jul 1, 2020 Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Dec 28, 2021 Accepting new patients
Innovative Foot and Ankle, P.a. Foot & Ankle Surgery CurrentSince Aug 29, 2024 Accepting new patients
Westchester Podiatric Surgical, PC Foot & Ankle Surgery Current Accepting new patients

Locations

528 Boulevard
Kenilworth, NJ 07033
Phone (908) 276-6624

528 Boulevard
Ste A
Kenilworth, NJ 07033

119 Grove St
Montclair, NJ 07042
Phone (973) 744-3561

1250 Shakespeare Ave
Bronx, NY 10452
Phone (646) 350-1633

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

3003 New Hyde Park Rd
Ste 312
New Hyde Park, NY 11042
Phone (516) 492-3515

7 Christopher St
New York, NY 10014
Phone (212) 242-7718

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1821520933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD",
            "address_2": "STE 312",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421214",
            "telephone_number": "516-492-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 NEW HYDE PARK RD STE 312",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421214",
            "telephone_number": "516-492-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "POOJA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N007085-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.