SHOBA MENON (NPI# 1154481539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154481539 |
| Entity Type | Individual |
| Full Name | SHOBA MENON |
| Other Name | SHOBA MULLOTH |
| Credential | MD |
| Practice Address |
1866 Wading River Manor Rd Wading River NY 11792-2137 |
| Mailing Address |
1866 Wading River Manor Rd Po Box 625 Wading River NY 11792-2137 |
| Practice Telephone | 6319298787 |
| Practice Fax Number | 6319290350 |
| Mailing Telephone | 6319298787 |
| Mailing Fax Number | 6319290350 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2011-07-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2308051 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HIP | 230805 | 01 | |
| MAGNACARE | 364487963 | 01 | |
| VYTRA | RH2144630 | 01 | |
| ANTHEM | 136728 | 01 | |
| DEVON | 364487963 | 01 | |
| IGA | 364487963 | 01 | |
| EMP GOVT | 364487963 | 01 | |
| FIRST HEALTH | 5607709 | 01 | |
| 1199 | NY230805 | 01 | |
| PHCS | 9398762 | 01 | |
| VYTRA | HB2144626 | 01 | |
| UHC | 2504648 | 01 | |
| CIGNA | 5536793 | 01 | |
| VYTRA | EP2144629 | 01 | |
| ATLANTIS | MS0805 | 01 |
| Street Address |
1866 WADING RIVER MANOR RD |
| City | WADING RIVER |
| State | NY |
| Zip Code | 11792-2137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659816213 | Shoba Menon Md, PC | Internal Medicine | 1866 Wading River Manor Rd, Wading River, NY 11792-2137 | 2017-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265906085 | Puja Kakar Godhwani | Nurse Practitioner | 6144 Ny-25a, Building C Suite 13, Wading River, NY 11792 | 2019-01-15 |
| 1336557230 | Danielle Schneider | Social Worker | 177 Cliff Rd West, Wading River, NY 11792 | 2014-07-24 |
| 1023428018 | Kristin Ponzini | Speech-Language Pathologist | 154 Sylvan Dr, Wading River, NY 11792 | 2014-04-30 |
| 1508281478 | Melissa Ellen Taylor | Audiologist | 5964 Route 25a, Wading River, NY 11792 | 2014-02-28 |
| 1992142285 | Alyssa Marie Wruck | Dentist | 6336 Ny 25-a, Suite 2, Wading River, NY 11792 | 2013-05-28 |
| 1639421803 | Barbara O. Higgins | Nutritionist | 12540 N Wading River Road, Little Flower Services, Wading River, NY 11792 | 2012-10-11 |
| 1821308545 | Sarah Jeanne Hogan | Licensed Practical Nurse | 63 Dogwood Dr, Wading River, NY 11792 | 2010-10-15 |
| 1336461854 | George Gabriel Hershman | Pharmacist | 1815 Wading River Manorville Road, Wading River, NY 11792 | 2010-02-25 |
| 1225365950 | Anne Valerie Nienstedt | Family Medicine | 67 Karen Court, Wading River, NY 11792 | 2009-11-18 |
| 1497894828 | Katherine Edith Gosman | Physical Therapist | 2098 N Wading River Rd, Wading River, NY 11792 | 2007-02-05 |
| Find all providers in zip 11792 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174783567 | Sanjay Godhwani | Internal Medicine | 6144 Route 25a Ste 13, Wading River, NY 11792-2008 | 2008-06-10 |
| 1790971505 | Robert Bernard M.d. P.C. | Internal Medicine | 6144 Route 25a Bldg C, Suite 10, Wading River, NY 11792-2018 | 2007-09-15 |
| 1023098464 | Robert Bernard | Internal Medicine | 5972 Route 25a, Wading River, NY 11792-2001 | 2006-01-20 |
| 1285104257 | Island Comprehensive Care Inc. | Internal Medicine | 6144 Route 25a Ste 13, Wading River, NY 11792-2008 | 2018-12-03 |
| 1659816213 | Shoba Menon Md, PC | Internal Medicine | 1866 Wading River Manor Rd, Wading River, NY 11792-2137 | 2017-01-05 |
| 1568844801 | Wading River Medical Care PC | Internal Medicine | 5972 Route 25a, Wading River, NY 11792-2001 | 2015-06-23 |
| 1689963753 | Juan Lin | Internal Medicine | 6144 Route 25a, Ste 13, Wading River, NY 11792-2008 | 2011-03-29 |
| 1811132632 | Neil D Jaglall | Internal Medicine | 6144 Route 25a, Ste 13, Wading River, NY 11792-2008 | 2008-12-08 |
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| Find all providers with the same taxonomy | ||||
| City | WADING RIVER |
| Zip Code | 11792 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.