Morteza Shahamat, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA53340 Issued in NJ

Practice address

400 Franklin Tpke
Suite 104
Mahwah, NJ 07430

Phone

(201) 995-1005

Fax

(201) 995-1007

NPI assigned

Sep 20, 2006

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

Other identifiers 3

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

Merit-based Incentive Payment System (MIPS)

Final score

95.05 of 100Reported as apm

Quality

85.71

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sovereign Medical Group LLC

  • Urology Physician
  • Oradell, NJ
  • NPI 1710282082

  Internal Medicine

  Medicare reassignment NPD
• Sovereign Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Glen Rock, NJ
  • NPI 1801266275
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1154429959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FRANKLIN TPKE",
            "address_2": "SUITE 104",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "07430",
            "telephone_number": "201-995-1005",
            "fax_number": "201-995-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FRANKLIN TPKE",
            "address_2": "SUITE 104",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "07430",
            "telephone_number": "201-995-1005",
            "fax_number": "201-995-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAMAT",
        "first_name": "MORTEZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA53340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "459516",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501700901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "BP257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Samaan
• Larissa Mae Saveri
• Michael Scrimenti, M.D.
• Select Physical Therapy Holdings Inc
• Song Woo Seo, DPM
• Madeeha Shahzadi, MD
• Indu Sharma, M.D.
• Mary Ellen Rita Shea, LSW
• Gary Allan Shiffman, P.T.
• Corinne Shustyk, PT, DPT

• Internal Medicine Physician in Mahwah, NJ
• Providers in Mahwah, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.