Khashayar Shakiba, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA08288700 Issued in NJ

Practice address

1 Kalisa Way Ste 103
Paramus, NJ 07652-3508

Phone

(201) 301-2772

Fax

(201) 882-8422

NPI assigned

Jun 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Women's Pelvic Surgery of North Jersey, LLCGroup PAC ID 9032389796, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshakiba67487@northwell.direct-ci.com

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.

• Women's Pelvic Surgery of North Jersey, LLC

  • Medical Specialty Clinic/Center
  • Paramus, NJ
  • NPI 1417243197
  Medicare reassignment Care Compare group NPD Authorized official
• Women Pelvic Surgery of North Jersey LLC

  • Obstetrics & Gynecology Physician
  • Wayne, NJ
  • NPI 1578875266
  NPD Authorized official
• Womens Healthcare of North Jersey, LLC

  • Specialist
  • Newfoundland, NJ
  • NPI 1265620231
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack University Medical Center

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1114121571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 HIGHLAND AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504001",
            "telephone_number": "201-301-2772",
            "fax_number": "201-882-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY STE 103",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523508",
            "telephone_number": "201-301-2772",
            "fax_number": "201-882-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIBA",
        "first_name": "KHASHAYAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08288700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Johnathan Sgobba, MD
• Dana Shafer, CSW MSW
• Apeksha K Shah
• Rutvi Desai Shah, O.D.
• Viral Jagdishbhai Shah, M.D.
• Fnu Shamail Ahmed
• Amin Shamal, M.D.
• Rachel Anne Shamash, D.D.S.
• Revathi Shanmugham, M.D.
• Emily Shapiro

• Obstetrics & Gynecology Physician in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.