Active NPI
Raphael I Shapiro, M.D.
- Surgery Physician
- Santa Fe, NM
National Provider Identifier
1073508891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 80253
- Practice address
- 1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728 - Phone
- (505) 913-3975
- Fax
- (505) 986-8001
- NPI assigned
- Sep 19, 2005
- Reactivated
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 80253 | NM | |
| Surgery Physician | 208600000X | 80253 | NM | Primary |
Addresses
Primary practice location
1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728
Mailing address
1631 Hospital Dr
Suite 240
Santa Fe, NM 87505-4728
Phone (505) 913-3975
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202007840 | Other | PRESBYTERIAN HEALTH PLANS | |
| 740201 | Other | UHC | |
| 10088011 | Other | LOVELACE | |
| NM012490 | Other | NM | BCBS NM |
| PROVP16424 | Other | MOLINA | |
| 12781 | Medicaid | NM | |
| 38702 | Other | CCN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80253 | NM | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1073508891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 HOSPITAL DR",
"address_2": "SUITE 240",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054728",
"telephone_number": "505-913-3975",
"fax_number": "505-986-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 HOSPITAL DR",
"address_2": "SUITE 240",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054728",
"telephone_number": "505-913-3975",
"fax_number": "505-986-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAPIRO",
"first_name": "RAPHAEL",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2010-08-12",
"deactivation_date": "2006-03-23",
"reactivation_date": "2006-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "80253",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "80253",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH PLANS",
"identifier": "202007840",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "740201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE",
"identifier": "10088011",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NM",
"identifier": "NM012490",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "PROVP16424",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12781",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCN",
"identifier": "38702",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.