Individual provider Active NPI

Michael B. Shapiro, MD

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1104869791
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA04006500 Issued in NJ
Practice address
651 Coney Island Ave
Suite #C
Brooklyn, NY 11218-4306
Phone
(718) 826-2000
Fax
(718) 826-2100
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA04006500 NJ Primary
Diagnostic Radiology Physician 2085R0202X 135080-1 NY

Addresses

Primary practice location

651 Coney Island Ave
Suite #C
Brooklyn, NY 11218-4306

Mailing address

651 Coney Island Ave
Suite #C
Brooklyn, NY 11218-4306
Phone (718) 826-2000

Other identifiers 2

IdentifierTypeStateIssuer
00508109MedicaidNY
5055504MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040602000137 NJ Practitioner - Diagnostic Radiology 2769464072 Practice locations: Englewood, NJ
I20050118001000 NY Practitioner - Diagnostic RadiologyPractitioner - General Practice 2769464072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013580NYMDChiropractor
25MA04006500NJMDDiagnostic Radiology Physician
135080-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health Administrative Services Inc. Diagnostic Radiology CurrentSince Jan 24, 2023 Accepting new patients
Sonographics Imaging Inc CurrentSince Nov 1, 2022 Accepting new patients
Westchester Square Imaging Associates PC Diagnostic Radiology Past Accepting new patients
Northfield Imaging Center PA Diagnostic Radiology PastSince Aug 14, 2010 Accepting new patients
Vidya Malhotra Radiology PC Diagnostic Radiology Past Accepting new patients
Englewood Imaging Center, PA Diagnostic Radiology Past Accepting new patients
Forest Hills Diagnostic Imaging, PC Diagnostic Radiology Past Accepting new patients
Yonkers Imaging PC Diagnostic Radiology Past Accepting new patients
The New Jersey Imaging Network, LLC Past Accepting new patients
Hia Bensonhurst Imaging Associates, LLP Past Accepting new patients
Radiological Diagnostic Center Medical Association, PA Past Accepting new patients

Locations

95 Cedar Ln
Englewood, NJ 07631
Phone (914) 777-7100

Organizations & group practices 11

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1104869791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 CONEY ISLAND AVE",
            "address_2": "SUITE #C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184306",
            "telephone_number": "718-826-2000",
            "fax_number": "718-826-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CONEY ISLAND AVE",
            "address_2": "SUITE #C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184306",
            "telephone_number": "718-826-2000",
            "fax_number": "718-826-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA04006500",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "135080-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00508109",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5055504",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.