Deepa Rasendu Shah, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA11282100 Issued in NJ

Practice address

140 Park Ave
Florham Park, NJ 07932-1049

Phone

(973) 404-7880

NPI assigned

Mar 27, 2018

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

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

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dshah109774@direct.optum.com

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.

• Optum Medical Care of New Jersey PC

  • Pediatrics Physician
  • New Hyde Park, NY
  • NPI 1578665048

  Internal Medicine, NJ

  Medicare reassignment Care Compare group NPD
• Optum Medical Care of New Jersey PC

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD
• A.G. Dikengil, MD, PA

  • Radiology Clinic/Center
  • Lyndhurst, NJ
  • NPI 1205992690
  NPD (past)
• Riverside Medical Group

  • Nurse Practitioner
  • Secaucus, NJ
  • NPI 1053867598
  NPD (past)

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1992200406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321049",
            "telephone_number": "973-404-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DEEPA",
        "middle_name": "RASENDU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11282100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Segal, L.AC
• Constance Seligman, MSW
• Suzanne M Sena, EDS, MA, LPC
• Samantha Senatore
• Thomas Sernas, PA-C
• Purvy A Shah, DMD
• Vaishali Shah
• Shany Shaji, APN
• Soma Shanker, M.D.
• Renae Elizabeth Sharkey

• Internal Medicine Physician in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.