Individual provider Active NPI

Shana Mencher, M.D.

  • Pediatric Endocrinology Physician
  • New Brunswick, NJ
National Provider Identifier
1053706887
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
061540 Issued in CT
Practice address
254 Easton Ave
New Brunswick, NJ 08901-1766
Phone
(732) 565-5437
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 61540 CT
Pediatric Endocrinology Physician 2080P0205X 061540 CT Primary

Addresses

Primary practice location

254 Easton Ave
New Brunswick, NJ 08901-1766

Mailing address

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 565-5437

Other names 1

  • Dr. Shana Flicker Former name

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
I20211206000447 NJ Practitioner - EndocrinologyPractitioner - Pediatric Medicine 0244620383 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
061540CTMDPediatric Endocrinology Physician
61540CTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Peter's Specialty Physicians, P.C. CurrentSince Oct 1, 2023 Accepting new patients
Saint Peter's University Hospital CurrentSince Oct 18, 2021 Accepting new patients
Saint Peter's Healthcare System Physician Associates CurrentSince Mar 20, 2023 Accepting new patients
Saint Peter's University Hospital CurrentSince Oct 18, 2021 Accepting new patients

Locations

308 Willow Ave
Fl 1
Hoboken, NJ 07030
Phone (201) 620-3120

500 River Ave
Ste 110
Lakewood, NJ 08701
Phone (732) 339-7360

254 Easton Ave
Ofc
New Brunswick, NJ 08901
Phone (732) 745-6674

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

254 Easton Ave
Fl 3
New Brunswick, NJ 08901
Phone (732) 745-8574

240 Easton Ave
Fl 3
New Brunswick, NJ 08901
Phone (732) 565-5453

Interoperability endpoints

  • Direct secure messaging: shana.mencher.1@8568.direct.athenahealth.com
  • Direct secure messaging: shana.mencher.3@8568.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1053706887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-565-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-565-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENCHER",
        "first_name": "SHANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "61540",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CT",
            "license": "061540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "FLICKER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.