DR. KETAN D. SHAH (NPI# 1609822360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609822360 |
| Entity Type | Individual |
| Full Name | DR. KETAN D. SHAH |
| Credential | D.P.M. |
| Practice Address |
9234 Kennedy Blvd North Bergen NJ 07047-5312 |
| Practice Telephone | 2018682400 |
| Practice Fax Number | 2018682014 |
| Mailing Telephone | 2018682400 |
| Mailing Fax Number | 2018682014 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2008-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
25MD00270100 | NJ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 8882401 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689959900 | Ketan Mahendra Shah | Nurse Practitioner | 422 N Prospect St, Wheaton, IL 60187-5839 | 2011-10-18 |
| 1407137102 | Ketan H Shah | Pharmacist | 153 Wood Ave, Edison, NJ 08820-3504 | 2011-09-08 |
| 1841306693 | Ketan Shah | Otolaryngology | 1000 Eleven S, Ste 4f, Columbia, IL 62236-1080 | 2006-08-22 |
| 1144575788 | Ketan Yogesh Shah | Internal Medicine | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2012-07-19 |
| 1922390210 | Ketan R Shah | Nurse Anesthetist, Certified Registered | 3200 Tyre Neck Rd, Suite 101, Portsmouth, VA 23703-3329 | 2011-05-05 |
| 1790001535 | Ketan Vikrambhai Shah | Internal Medicine | 300 Highland Ave, Hanover, PA 17331-2297 | 2010-04-19 |
| 1629244652 | Ketan K Shah | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2008-04-30 |
| 1871507053 | Ketan Shah | Internal Medicine | 5500 Armstrong Rd, Battle Creek, MI 49015-1014 | 2006-07-27 |
| 1528098134 | Ketan Shah | Internal Medicine | 2211 E Franklin Blvd, Ste 100, Gastonia, NC 28054-4985 | 2006-07-03 |
| 1083664023 | Ketan S. Shah | Internal Medicine | 3120 Governors Place Blvd, Dayton, OH 45409-1328 | 2006-05-11 |
| Street Address |
9234 KENNEDY BLVD |
| City | NORTH BERGEN |
| State | NJ |
| Zip Code | 07047-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700817186 | Achilles Foot and Ankle Group LLC | Podiatrist | 9234 Kennedy Blvd, North Bergen, NJ 07047-5312 | 2006-07-05 |
| 1285672022 | Franklin N. Levinson | Podiatrist | 9234 Kennedy Blvd, North Bergen, NJ 07047-5312 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850490 | Maria Purita Yballe | Nurse Practitioner | 8100 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2020-10-29 |
| 1639799646 | Red Oak Pharmacy Corp | Pharmacy | 9225 John F Kennedy Blvd, Unit F, North Bergen, NJ 07047 | 2020-04-20 |
| 1811520091 | Andres A Varilias | Pharmacist | 7917 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2020-02-17 |
| 1669016986 | Rebecca Lee | Dentist | 3123 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2019-10-30 |
| 1720648439 | Hannah Joy Guharajan | Speech-Language Pathologist | 5665 John F. Kennedy Blvd, Apt. 508, North Bergen, NJ 07047 | 2019-06-14 |
| 1417417080 | Chandini Sajja | Student in an Organized Health Care Education/Training Program | 7600 River Road, North Bergen, NJ 07047 | 2019-03-20 |
| 1215455522 | Xavier Steven Alzate | Specialist/Technologist | 338 75th Street, 2b, North Bergen, NJ 07047 | 2017-09-07 |
| 1962923151 | Hala Altunji | Dentist | 8407 Jfk Blvd E, North Bergen, NJ 07047 | 2017-06-28 |
| 1871023457 | Diego Nieto | Specialist | 6112 Durham Ave, North Bergen, NJ 07047 | 2017-06-15 |
| 1326578105 | Hudson Hills Senior Living, LLC | Nursing Care | 3505 Bergen Tpke, North Bergen, NJ 07047 | 2017-06-14 |
| Find all providers in zip 07047 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093217622 | Active Podiatry LLC | Podiatrist | 7823 Bergenline Ave Fl 2, North Bergen, NJ 07047-4942 | 2018-02-28 |
| 1467429324 | Peter John Iannuzzi | Podiatrist | 7817 Bergenline Ave, North Bergen, NJ 07047-4942 | 2006-02-28 |
| 1144200445 | Demetrios S Econopouly | Podiatrist | 9226 Kennedy Blvd, 2nd Floor, North Bergen, NJ 07047-5312 | 2006-01-20 |
| 1619595659 | Dr Dina Ibrahim Foot & Ankle Surgery LLC | Podiatrist | 7600 River Rd, North Bergen, NJ 07047-6217 | 2020-07-07 |
| 1376046276 | Royale Foot and Ankle Surgeons | Podiatrist | 7823 Bergenline Ave Fl 2, North Bergen, NJ 07047-4942 | 2018-03-16 |
| 1396926119 | A Center for Foot and Ankle Surgery, P.a. | Podiatrist | 7521 Bergenline Ave, North Bergen, NJ 07047-5459 | 2007-11-20 |
| 1437293958 | Dpm0016mllc | Podiatrist | 7406 Bergenline Ave, North Bergen, NJ 07047-5449 | 2007-02-17 |
| 1447287511 | Luis Leal | Podiatrist | 7600 River Rd, 2nd Floor, North Bergen, NJ 07047-6217 | 2006-06-26 |
| 1285672022 | Franklin N. Levinson | Podiatrist | 9234 Kennedy Blvd, North Bergen, NJ 07047-5312 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350120 | Lower Limb Institute | Podiatrist | 211 Esses Street, Suite 405, Hackesack, NJ 07601 | 2020-09-09 |
| 1275162315 | Mercer-ocean Podiatry | Podiatrist | 666 Plainsboro Rd Ste 1050, Plainsboro, NJ 08536-3044 | 2020-04-01 |
| 1386279552 | Liberty Med Associates LLC | Podiatrist | 1 Bethany Rd Ste 21, Hazlet, NJ 07730-1660 | 2020-03-09 |
| 1659905685 | New Jersey Podiatric Physicians & Surgeons Group LLC | Podiatrist | 132 Franklin Corner Rd Ste C1, Lawrenceville, NJ 08648-2523 | 2020-02-28 |
| 1891270609 | Syracuse Medical LLC | Podiatrist | 5 Franklin Ave Ste 103, Belleville, NJ 07109-3521 | 2018-09-27 |
| 1912481946 | Dr Emad Youssef Podiatry LLC | Podiatrist | 14 W 11th St Fl 1, Bayonne, NJ 07002-2508 | 2018-09-14 |
| 1932686334 | Kinetic Foot and Ankle, LLC | Podiatrist | 1030 Mcbride Ave Unit 103, Woodland Park, NJ 07424-2535 | 2018-07-27 |
| 1346730215 | J M Podiatry Associates PC | Podiatrist | 121 Route 31 Ste 700, Flemington, NJ 08822-5754 | 2018-05-15 |
| 1235629783 | Belvidere Foot & Ankle LLC | Podiatrist | 8 Greenwich St, Belvidere, NJ 07823-1421 | 2018-05-10 |
| 1922507003 | Muntasir Khaled | Podiatrist | 417 Memorial Pkwy, Bloomfield, NJ 07003-4266 | 2018-02-05 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BERGEN |
| Zip Code | 07047 |
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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.