Individual provider Active NPI

Susan Elizabeth Shirato, DNP, CRNP

  • Nurse Practitioner
  • Voorhees, NJ
National Provider Identifier
1093055709
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00472800 Issued in NJ
Practice address
200 Bowman Dr Ste E385
Voorhees, NJ 08043-9638
Phone
(856) 840-4534
Fax
(856) 762-2853
NPI assigned
Feb 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00472800 NJ Primary

Addresses

Primary practice location

200 Bowman Dr Ste E385
Voorhees, NJ 08043-9638

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 840-4534

Other identifiers 4

IdentifierTypeStateIssuer
CD4829OtherPATPI RAILROAD MEDICARE GROUP ID
0672122MedicaidNJ
597586OtherPATPI GROUP MEDICARE NUMBER
1007278000OtherPATPI PA MEDICAID GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sshirato231674@directvirtua.org

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
I20180926001340 NJ Practitioner - Nurse Practitioner 0042442972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00472800NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince Sep 21, 2021 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2022 Accepting new patients
Virtua Medical Group, PA Nurse Practitioner CurrentSince Aug 1, 2022 Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Nurse Practitioner Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1412 Marlton Pike E
Cherry Hill, NJ 08034
Phone (856) 428-1600

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

10 Sterling Dr
Piscataway, NJ 08854
Phone (732) 917-2900

113 Route 73
Voorhees, NJ 08043
Phone (856) 809-3500

200 Bowman Dr
Ste E385
Voorhees, NJ 08043
Phone (856) 247-7220

L2540
Columbus, OH 43260

Interoperability endpoints

  • Direct secure messaging: sshirato231674@directvirtua.org

Organizations & group practices 6

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": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1093055709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-840-4534",
            "fax_number": "856-762-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOWMAN DR STE E385",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439638",
            "telephone_number": "856-840-4534",
            "fax_number": "856-762-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRATO",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-18",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00472800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI RAILROAD MEDICARE GROUP ID",
            "identifier": "CD4829",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672122",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI GROUP MEDICARE NUMBER",
            "identifier": "597586",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI PA MEDICAID GROUP",
            "identifier": "1007278000",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sshirato231674@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste E385",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.