Individual provider Active NPI

Jason Shapiro, MD

  • Pediatric Gastroenterology Physician
  • Providence, RI
National Provider Identifier
1023235751
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD12750 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-8450
Fax
(401) 444-5088
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X MD12750 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-8306

Other identifiers 1

IdentifierTypeStateIssuer
MD12750OtherRILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20110819000043 RI Practitioner - GastroenterologyPractitioner - Pediatric Medicine 4183894611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Pediatric Medicine
Education
University of Vermont College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Jul 1, 2011 Accepting new patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Feb 11, 2020 Accepting new patients
Rhode Island Hospital CurrentSince Jul 1, 2011 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Feb 11, 2020 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 1300
East Greenwich, RI 02818
Phone (401) 432-6800

701 George Washington Hwy
Ste 104
Lincoln, RI 02865
Phone (401) 444-8311

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

593 Eddy St
Providence, RI 02903

593 Eddy St
#921
Providence, RI 02903
Phone (401) 444-3250

Interoperability endpoints

  • Direct secure messaging: jshapiro12183@brownhealth.medalliesdirect.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1023235751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8306",
            "fax_number": "401-444-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8450",
            "fax_number": "401-444-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "RI",
            "license": "MD12750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD12750",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.