Active NPI
Neena Y Shah, M.D.
- Pediatrics Physician
- Tracy, CA
National Provider Identifier
1831195692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- K6312
- Practice address
- 4598 S Tracy Blvd
C140
Tracy, CA 95377-8107 - Phone
- (209) 839-1432
- Fax
- (209) 839-8681
- NPI assigned
- Jun 24, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | K6312 | TX | Primary |
Addresses
Primary practice location
4598 S Tracy Blvd
C140
Tracy, CA 95377-8107
Mailing address
11875 Dublin Blvd
C140
Dublin, CA 94568-2843
Phone (925) 587-2500
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123727101 | Other | TX | FIRST CARE PROV NUMBER |
| 125863403 | Medicaid | TX | |
| 5252625 | Other | TX | AETNA PROVIDER NUMBER |
| 6912142001 | Other | TX | CIGNA PROVIDER NUMBER |
| 181846303 | Other | TX | UNITED HEALTHCARE PROV NO |
| 89110G | Other | TX | BCBS PROVIDER NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53230 | CA | MD | Dentist |
| K6312 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350432000000",
"number": "1831195692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11875 DUBLIN BLVD",
"address_2": "C140",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682843",
"telephone_number": "925-587-2500",
"fax_number": "925-587-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4598 S TRACY BLVD",
"address_2": "C140",
"city": "TRACY",
"state": "CA",
"postal_code": "953778107",
"telephone_number": "209-839-1432",
"fax_number": "209-839-8681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "NEENA",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-24",
"last_updated": "2012-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "K6312",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CARE PROV NUMBER",
"identifier": "123727101",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125863403",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "5252625",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "6912142001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PROV NO",
"identifier": "181846303",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "89110G",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.