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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. KULSOOM SHAH M.D
NPI 1114920360
Family Medicine in Stony Brook, NY

Active since May 23, 2005PECOS Enrolled
1 STADIUM RD,STUDENT HEALTH CENTER,STONYBROOK UNIV, STONY BROOK, NY 11794(631) 632-6740(631) 632-6936 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kulsoom Shah M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KULSOOM SHAH M.D (NPI 1114920360) is an individual family medicine provider in Stony Brook, New York, licensed in New York (224192-1) and active in the NPI registry since May 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114920360
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KULSOOM SHAHCredential: M.D
Location Address1 STADIUM RD,STUDENT HEALTH CENTER,STONYBROOK UNIVStony Brook, NY 11794-0001
Mailing Address52 Avalon CirSmithtown, NY 11787-3855 · (631) 863-1634 · Fax (631) 632-6936
Phone(631) 632-6740
Fax(631) 632-6936
Sole ProprietorNo
Enumeration DateMay 23, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1114920360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 224192-1
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1 STADIUM RD,STUDENT HEALTH CENTER,STONYBROOK UNIV, Stony Brook, NY 11794
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kulsoom Shah M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kulsoom Shah's NPI number?

The NPI number for Kulsoom Shah is 1114920360. It was assigned to this individual provider in the NPPES registry on May 23, 2005.

Where is Kulsoom Shah located?

Kulsoom Shah practices at 1 Stadium Rd,student Health Center,stonybrook Univ, Stony Brook, NY 11794. The listed phone number is (631) 632-6740.

What is Kulsoom Shah's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kulsoom Shah enrolled in Medicare?

Yes. Kulsoom Shah is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kulsoom Shah was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.