Kavitha Shah, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA09499600 Issued in NJ

Practice address

1135 Broad St
Clifton, NJ 07013-3346

Phone

(973) 754-4100

NPI assigned

Aug 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kavitha Sebamalai Former name

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garden State Healthcare Associates LLCGroup PAC ID 8426190687, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Garden State Healthcare Associates, LLC

  • Emergency Medicine Physician
  • Bayonne, NJ
  • NPI 1700014545
  Medicare reassignment Care Compare group NPD
• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696

  Family Medicine

  Medicare reassignment NPD
• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment NPD
• Advocare , LLC

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD
• Virtua Medical Group, PA

  • Urgent Care Clinic/Center
  • Haddon Township, NJ
  • NPI 1932659778
  NPD

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1881974574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133346",
            "telephone_number": "973-754-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133346",
            "telephone_number": "973-754-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KAVITHA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09499600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshah17551@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAVITHA",
            "last_name": "SEBAMALAI",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Sevillano
• Seymour W Thomas
• Anish Jayesh Shah, MD
• Dilip Amrytlal Shah, MD
• Hiten N Shah
• Kimi Sudhir Shah
• Neepa Bankim Shah, DMD
• Poorna Bhaskar Shah
• Shital P Shah, D.O.
• Shivani V Shah, DO

• Family Medicine Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.