Individual provider Active NPI

Mark Shapiro, MD

  • Specialist
  • Flushing, NY
National Provider Identifier
1104866037
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
190231 Issued in NY
Practice address
4355 147TH St
Flushing, NY 11355-1736
Phone
(718) 762-0900
Fax
(718) 886-5659
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 190231 NY Primary
Specialist 174400000X 25MA06924400 NJ

Addresses

Primary practice location

4355 147TH St
Flushing, NY 11355-1736

Mailing address

560 S Broadway
Hicksville, NY 11801-5027
Phone (516) 933-2800

Other identifiers 2

IdentifierTypeStateIssuer
01663741MedicaidNY
10471456OtherNYCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040525001766 NY Practitioner - Diagnostic Radiology 9830170968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lenox Hill Radiology and Medical Imaging Associates PCGroup PAC ID 2264424712, 245 clinicians

Practice addresses (Care Compare)

61 E 77TH St
New York, NY 10075-1817
Phone (212) 772-3111

Merit-based Incentive Payment System (MIPS)

Final score
81.08 of 100Reported as group
Quality
62.84
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06924400NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Radiology & Medical Imaging Associates, PC CurrentSince Dec 1, 2015 Accepting new patients
Hudson Valley Radiology Associates PLLC CurrentSince Aug 13, 2023 Accepting new patients
Rockaway Medical&Diagnostic, P.C. Past Accepting new patients

Locations

27443 Network Pl
Chicago, IL 60673

410 E 189th St
Bronx, NY 10458
Phone (718) 220-2500

2475 Ralph Ave
Brooklyn, NY 11234
Phone (718) 444-3777

2215 79th St
Brooklyn, NY 11214
Phone (718) 222-3000

6740 3rd Ave
Brooklyn, NY 11220
Phone (718) 491-5822

8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532

4355 147th St
Flushing, NY 11355
Phone (718) 670-4550

3717 76th St
Jackson Hts, NY 11372
Phone (718) 424-1400

18 Squadron Blvd
New City, NY 10956
Phone (845) 368-3002

315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

111 N Highland Ave
Nyack, NY 10960
Phone (845) 639-6178

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104866037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015027",
            "telephone_number": "516-933-2800",
            "fax_number": "516-933-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 147TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551736",
            "telephone_number": "718-762-0900",
            "fax_number": "718-886-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "190231",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA06924400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01663741",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10471456",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.