Individual provider Active NPI

Reza Ali Shah, DO

  • Vascular Surgery Physician
  • Hamilton, NJ
National Provider Identifier
1891740080
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MB06764700 Issued in NJ
Practice address
2063 Klockner Rd
Hamilton, NJ 08690-3414
Phone
(609) 586-9788
Fax
(609) 586-1232
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 25MB06764700 NJ Primary

Addresses

Primary practice location

2063 Klockner Rd
Hamilton, NJ 08690-3414

Mailing address

PO Box 3444
Mercerville, NJ 08619-0444
Phone (609) 586-9788

Other identifiers 10

IdentifierTypeStateIssuer
2690963000OtherNJAMERIHEALTH
3K2190OtherNJHEALTHNET
5727757OtherNJAETNA
7180223002OtherNJCIGNA
P1626337OtherNJOXFORD
7947801MedicaidNJ
203985484OtherNJTAX ID
2039854840OtherNJHORIZON
60032148OtherNJHORIZON NJ HEALTH
7279755OtherNJUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051027000074 NJ Practitioner - General SurgeryPractitioner - Vascular Surgery 4486671641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Rowan University School of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

1 Hamilton Health PL
Hamilton, NJ 08690-3542
Phone (609) 689-7031

475 Hwy 70
Suite 101
Lakewood, NJ 08701-5897
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Varicose vein removal1-10
Removal of tissue116
Removal of skin lesions29
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Oct 2, 2021 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 2, 2021 Accepting new patients
Barnabas Health Medical Group, PC CurrentSince Nov 1, 2020 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

2063 Klockner Rd
Trenton, NJ 08690
Phone (609) 586-1500

3575 Quakerbridge Rd
Fl 2
Trenton, NJ 08619

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Interoperability endpoints

  • Direct secure messaging: rshah46166@epicdirect.rwjbh.org

Organizations & group practices 3

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 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1891740080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3444",
            "city": "MERCERVILLE",
            "state": "NJ",
            "postal_code": "086190444",
            "telephone_number": "609-586-9788",
            "fax_number": "609-586-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2063 KLOCKNER RD",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086903414",
            "telephone_number": "609-586-9788",
            "fax_number": "609-586-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "REZA",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MB06764700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2690963000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K2190",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5727757",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7180223002",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1626337",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7947801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "203985484",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "2039854840",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60032148",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7279755",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.