MEDICARE: DR. SHANTILAL KENIA M.D., FACC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	47638	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	BX9518	OTHER	MA	MEDICARE PTAN
6	060057516	OTHER	MA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	052430	OTHER	MA	CONNECTICARE
2	13550	OTHER	MA	HEALTH NEW ENGLAND
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	J02371	OTHER	MA	BCBS OF MASSACHUSETTS
7	300110	OTHER	MA	HARVARD PILGRIM HEALTHCAR
8	047638	OTHER	MA	TUFTS
9	98128301	OTHER	MA	NETWORK HEALTH

General Provider Information

NPI Number	:	1629062161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANTILAL KENIA M.D., FACC

Provider Business Mailing Address
First Line	:	280 CHESTNUT STREET
Second Line	:	2ND FLOOR
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:	413-794-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 W SILVER ST FL 1
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-3678
Country	:	US
Telephone Number	:	413-562-8088
Fax Number	:	413-562-8006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	03/25/2026

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Directions to “ DR. SHANTILAL KENIA M.D., FACC” Practice Location

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