Individual provider Active NPI

Emanoil Shafik, DPM

  • Podiatrist
  • Bayonne, NJ
National Provider Identifier
1083308266
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N007500 Issued in NY
Practice address
77 W 19TH St
Bayonne, NJ 07002-2638
Phone
(347) 576-4417
NPI assigned
Jun 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00391100 NJ
Podiatrist 213E00000X N007500 NY Primary

Addresses

Primary practice location

77 W 19TH St
Bayonne, NJ 07002-2638

Mailing address

55 Southwood Dr
Old Bridge, NJ 08857-1461
Phone (347) 576-4417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260402002176 NY Practitioner - Podiatry 9537644976 Reassigns benefits to 1 organization
I20260601002370 NJ Practitioner - Podiatry 9537644976

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1042 Huguenot Ave
Staten Island, NY 10312-4315

523 Broadway
Bayonne, NJ 07002-3735

55 Southwood Dr
Old Bridge, NJ 08857-1461

55 Water St
FL 2
New York, NY 10041-0029

Advantagecare Physicians PC
New York, NY 10041-0010

PO Box
Suite 486
Central Valley, NY 10917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00391100NJMDPodiatrist
N007500NYMDPodiatrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1083308266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SOUTHWOOD DR",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571461",
            "telephone_number": "347-576-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W 19TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022638",
            "telephone_number": "347-576-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIK",
        "first_name": "EMANOIL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00391100",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N007500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.