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SHAN NAGENDRA,M.D.P.C.
NPI 1174705776
Specialist in Bayonne, NJ

Active since December 05, 2007
654 AVENUE C, BAYONNE, NJ 07002(201) 823-3390(201) 823-4420 Get Directions Write a Review

NPPES record last updated: December 5, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shan Nagendra,m.d.p.c. NPPES

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

SHAN NAGENDRA,M.D.P.C. (NPI 1174705776) is a healthcare organization registered as a specialist in Bayonne, New Jersey and active in the NPI registry since December 2007. The organization lists Shan Nagendra, Owner, as its authorized official.

NPPES Registry Identity

NPI1174705776
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSHAN NAGENDRA,M.D.P.C.
Location Address654 AVENUE CBayonne, NJ 07002-3899
Mailing Address654 Avenue CBayonne, NJ 07002-3899 · (201) 823-3390 · Fax (201) 823-4420
Phone(201) 823-3390
Fax(201) 823-4420
Organization SubpartNo
Authorized OfficialShan NagendraOwner · (201) 823-3390
Enumeration DateDecember 5, 2007
✔ NPI 1174705776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NJ · MA30013
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
654 AVENUE C, Bayonne, NJ 07002
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Other Identifiers 2

Medicaid3195503NJ
Medicare UPINE54333NJ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shan Nagendra,m.d.p.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Shan Nagendra,m.D.P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Shan Nagendra, M.D.
Neurology
NPI 1164533659
246 BARKLEY AVE
Clifton, NJ 07011
(862) 899-7531
✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Shan Nagendra,m.D.P.C.'s NPI number?

The NPI number for Shan Nagendra,m.D.P.C. is 1174705776. It was assigned to this organization in the NPPES registry on December 5, 2007.

Where is Shan Nagendra,m.D.P.C. located?

Shan Nagendra,m.D.P.C. is located at 654 Avenue C, Bayonne, NJ 07002. The listed phone number is (201) 823-3390.

What is Shan Nagendra,m.D.P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Shan Nagendra,m.D.P.C. enrolled in Medicare?

Yes. Shan Nagendra,m.D.P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shan Nagendra,m.D.P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Neurology) reassigns their Medicare billing to Shan Nagendra,m.D.P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Shan Nagendra,m.D.P.C. was last updated on December 5, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.