Shaily Ketanbhai Shah, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

J1-0003907 Issued in CT

Practice address

106 Milford St Ste 601
Salisbury, MD 21804-6938

Phone

(410) 548-7600

Fax

(410) 548-2651

NPI assigned

May 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shasta Health Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • San Francisco, CA
  • NPI 1063292241

  Physical Therapist

  Medicare reassignment NPD
• Revive Roots Physical Therapy

  • Physical Therapist
  • Union City, CA
  • NPI 1558245076
  NPD Authorized official

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1821653148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S SALISBURY BLVD STE 1B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015458",
            "telephone_number": "410-831-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST STE 601",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046938",
            "telephone_number": "410-548-7600",
            "fax_number": "410-548-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHAILY",
        "middle_name": "KETANBHAI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "J1-0003907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "J1-0003907",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryann Rose Sestito, PHARMD, RPH
• Brian F Seymour Jr.
• SG Dental Services LLC
• Usama Bin Shabbir
• Mark Alan Shaffer, LCSW-C
• Janat Shahbaz, RBT
• Mubasshar Shahid, M.D.
• Shaik Abdul MD LLC
• Sophia Shakur, M.D.
• Michelle Shannon, CRNP

• Physical Therapist in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.