Individual provider Active NPI

Evan Shapiro

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1124551353
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
301560-01 Issued in NY
Practice address
506 6TH Street
Newyork Presbyterian Brooklyn Methodist Hospital
Brooklyn, NY 11215
Phone
(718) 780-3000
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 301560-01 NY Primary

Addresses

Primary practice location

506 6TH Street
Newyork Presbyterian Brooklyn Methodist Hospital
Brooklyn, NY 11215

Mailing address

506 6TH Street
Newyork Presbyterian Brooklyn Methodist Hospital
Brooklyn, NY 11215
Phone (718) 780-3000

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
I20200609000349 NY Practitioner - Emergency Medicine 5092136523 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
301560-01NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Mar 1, 2021 Accepting new patients
Rite Medical Care PC Emergency Medicine CurrentSince Nov 4, 2022 Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2020 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

17811 Union Tpke
Fresh Meadows, NY 11366
Phone (516) 729-7282

46 Main St
Ste 148
Monsey, NY 10952
Phone (917) 740-3853

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

175 Route 59
Spring Valley, NY 10977
Phone (845) 352-6800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1124551353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH STREET",
            "address_2": "NEWYORK PRESBYTERIAN BROOKLYN METHODIST HOSPITAL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-780-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH STREET",
            "address_2": "NEWYORK PRESBYTERIAN BROOKLYN METHODIST HOSPITAL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-780-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "301560-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.