Individual provider Active NPI

Mehul Shah

  • Pharmacist
  • Richmond Hill, NY
National Provider Identifier
1902454374
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
065958 Issued in NY
Practice address
11402 Jamaica Ave
Richmond Hill, NY 11418-2442
Phone
(718) 620-9000
NPI assigned
Aug 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 065958 NY Primary

Addresses

Primary practice location

11402 Jamaica Ave
Richmond Hill, NY 11418-2442

Mailing address

619 E 169TH St
Bronx, NY 10456-2605
Phone (718) 620-9000

Other practice location 1

619 E 169th St
Bronx, NY 10456-2605
Phone (718) 620-9000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
065958NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Drug Depot Corp PastSince Jan 1, 2020 Accepting new patients
Drug Depot Corp PastSince Jan 1, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1902454374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E 169TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104562605",
            "telephone_number": "718-620-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11402 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182442",
            "telephone_number": "718-620-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 E 169th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104562605",
            "country_code": "US",
            "telephone_number": "718-620-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MEHUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "065958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.