Individual provider Active NPI

Elliot Shulman, MD

  • Urology Physician
  • Jersey City, NJ
National Provider Identifier
1023037058
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
NJ6J652 Issued in NJ
Practice address
2255 Kennedy Blvd
Jersey City, NJ 07304
Phone
(201) 433-1057
Fax
(201) 435-2716
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NJ6J652 NJ Primary
Urology Physician 208800000X NY18753 NY

Addresses

Primary practice location

2255 Kennedy Blvd
Jersey City, NJ 07304

Mailing address

2255 Kennedy Blvd
Jersey City, NJ 07304
Phone (201) 433-1057

Other identifiers 1

IdentifierTypeStateIssuer
7312008MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110624000143 NJ Practitioner - Urology 9032397963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Albert Einstein College of Medicine of Yeshiva University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sovereign Medical Group LLCGroup PAC ID 1456535392, 20 clinicians

Practice addresses (Care Compare)

2255 John F Kennedy Blvd
Jersey City, NJ 07304-1428
Phone (201) 433-1057

Hospital & facility affiliations

  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074
  • Carepoint Health - Bayonne Medical Center Hospital, Bayonne, NJ, CCN 310025
  • Carepoint Health-Hoboken University Medical Center Hospital, Hoboken, NJ, CCN 310040
  • The University Hospital Hospital, Newark, NJ, CCN 310119
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NJ6J652NJMDUrology Physician
NY18753NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group, LLC CurrentSince Jul 1, 2011 Accepting new patients
Sovereign Medical Group LLC Urology CurrentSince Jul 1, 2011 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Urology Specialty Care PA Past Accepting new patients
Medical Associates of Englewood, PC Past Accepting new patients

Locations

807 Kennedy Blvd
Ste A
Bayonne, NJ 07002
Phone (201) 339-5799

85 Harristown Rd
Ste 200
Glen Rock, NJ 07452
Phone (201) 444-4526

85 Harristown Rd
Ste 1200
Glen Rock, NJ 07452

2255 John F Kennedy Blvd
Jersey City, NJ 07304
Phone (201) 433-1057

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

Interoperability endpoints

  • Direct secure messaging: elliott.shulman@direct.christhospital.md
  • FHIR API: https://fhir4.healow.com/fhir/r4/HFFCCA/Endpoint/HFFCCA

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023037058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304",
            "telephone_number": "201-433-1057",
            "fax_number": "201-435-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304",
            "telephone_number": "201-433-1057",
            "fax_number": "201-435-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "ELLIOT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "NJ6J652",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "NY18753",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7312008",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.