Individual provider Active NPI

Rasik V Shah, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1871553115
Registry record updated Jul 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
221047 Issued in NY
Practice address
10 Union SQ E FRNT 2J
New York, NY 10003-3314
Phone
(212) 844-8300
NPI assigned
Mar 23, 2006
Last updated
Jul 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2014

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 221047 NY Primary

Addresses

Primary practice location

10 Union SQ E FRNT 2J
New York, NY 10003-3314

Mailing address

PO Box 31694
Hartford, CT 06150
Phone (212) 256-3682

Other identifiers 1

IdentifierTypeStateIssuer
02238351MedicaidNY

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
I20050627001135 NY Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 1456396720 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2014 Accepting new patients
New York University Pediatrics CurrentSince Oct 1, 2014 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients
Specialist Peds at Lich Past Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600

97 Amity St
Brooklyn, NY 11201
Phone (718) 780-1025

97 Amity St
Spc Peds
Brooklyn, NY 11201
Phone (718) 780-1025

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: rshah682580@nychhc.direct-ci.com
  • Direct secure messaging: rshah95909@nyumc.direct-ci.com

Organizations & group practices 4

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404604800000",
    "number": "1871553115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31694",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06150",
            "telephone_number": "212-256-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E FRNT 2J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-844-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RASIK",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "221047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02238351",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.