Individual provider Active NPI

Siddhartha S Shah, M.D.

  • Gastroenterology Physician
  • Williamsville, NY
National Provider Identifier
1841276763
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
179451 Issued in NY
Practice address
60 Maple Rd
Ste 1
Williamsville, NY 14221-2917
Phone
(716) 626-5250
Fax
(716) 332-2218
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 179451 NY Primary

Addresses

Primary practice location

60 Maple Rd
Ste 1
Williamsville, NY 14221-2917

Mailing address

60 Maple Rd
Ste 1
Williamsville, NY 14221-2917
Phone (716) 626-5250

Other identifiers 9

IdentifierTypeStateIssuer
100013189OtherNYRAILROAD NEDICARE
153030BTOtherNYPREFERRED CARE
00010162901OtherNYUNIVERA
000511391004OtherNYBLUE CROSS OF WNY
2307716OtherNYINDEPENDENT HEALTH
2499566OtherNYGHI
01339624MedicaidNY
5289777OtherNYAETNA
040426001814OtherNYFIDELIS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100322000776 NY Practitioner - Gastroenterology 0840297537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates LLPGroup PAC ID 8820048085, 28 clinicians

Practice addresses (Care Compare)

60 Maple Rd
Suite 1
Williamsville, NY 14221-2917
Phone (716) 626-5250

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy340
Upper gastrointestinal (GI) endoscopy for acid reflux150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates, LLP Gastroenterology CurrentSince Jul 1, 1999 Accepting new patients
Gastrointestinal Group Gastroenterology PastSince Jul 1, 1999 Accepting new patients

Locations

6935 Elaine Dr
Niagara Falls, NY 14304
Phone (716) 626-5250

60 Maple Rd
#2
Williamsville, NY 14221
Phone (716) 332-1000

60 Maple Rd
#1
Williamsville, NY 14221
Phone (716) 626-5250

Interoperability endpoints

  • Direct secure messaging: sshah@gastrowny.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1841276763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "address_2": "STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MAPLE RD",
            "address_2": "STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212917",
            "telephone_number": "716-626-5250",
            "fax_number": "716-332-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SIDDHARTHA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "179451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD NEDICARE",
            "identifier": "100013189",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "153030BT",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010162901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF WNY",
            "identifier": "000511391004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "2307716",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2499566",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01339624",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5289777",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426001814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.