Individual provider Active NPI

David P. Shiller, MD

  • Emergency Medicine Physician
  • Turnersville, NJ
National Provider Identifier
1073554697
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MA57860 Issued in NJ
Practice address
435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone
(856) 582-2816
Fax
(856) 582-2712
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MA57860 NJ Primary

Addresses

Primary practice location

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300

Other identifiers 1

IdentifierTypeStateIssuer
5180902MedicaidNJ

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
I20040816000501 NJ Practitioner - Emergency Medicine 7719950005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Connecticut School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physician Associates of South Jersey P CGroup PAC ID 5294648457, 94 clinicians

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2816

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

Merit-based Incentive Payment System (MIPS)

Final score
72.53 of 100Reported as individual
Quality
46.67
Improvement activities
40
Cost
79.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA57860NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Apr 1, 1998 Accepting new patients

Locations

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200

18 W Laurel Rd
Stratford, NJ 08084
Phone (856) 345-7816

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

Organizations & group practices 1

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 1

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1073554697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453",
            "telephone_number": "856-582-2816",
            "fax_number": "856-582-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLER",
        "first_name": "DAVID",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA57860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5180902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

Verify at the official NPI Registry.