Individual provider Active NPI

Shirley Sabado Santos, MSN,RN,AGPCNP-C,CCRN

  • Adult Health Nurse Practitioner
  • Maplewood, NJ
National Provider Identifier
1053951186
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00947800 Issued in NJ
Practice address
2010 Springfield Ave
Maplewood, NJ 07040-3437
Phone
(973) 275-9500
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00947800 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ00947800 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ00947800 NJ Primary

Addresses

Primary practice location

2010 Springfield Ave
Maplewood, NJ 07040-3437

Mailing address

26 7TH Ave
Mine Hill, NJ 07803-3216
Phone (973) 879-4886

Other names 1

  • Shirley T Sabado 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200728000547 NJ Practitioner - Nurse Practitioner 9830513555 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians
Passaic Hospitalist Services, LLCGroup PAC ID 8426404484, 30 clinicians

Practice addresses (Care Compare)

224 Hamburg Tpke
Wayne, NJ 07470-2168
Phone (973) 569-6118

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Healthcare, Inc. CurrentSince Nov 1, 2021 Accepting new patients
St Josephs Medical Group PC CurrentSince Mar 10, 2022 Accepting new patients
Passaic Hospitalist Services, LLC CurrentSince Oct 28, 2023 Accepting new patients

Locations

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

Organizations & group practices 3

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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1053951186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 7TH AVE",
            "city": "MINE HILL",
            "state": "NJ",
            "postal_code": "078033216",
            "telephone_number": "973-879-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403437",
            "telephone_number": "973-275-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "SHIRLEY",
        "middle_name": "SABADO",
        "credential": "MSN,RN,AGPCNP-C,CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00947800",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00947800",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00947800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "SABADO",
            "middle_name": "T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.