Individual provider Active NPI

Mark L Shapiro, M.D.

  • Trauma Surgery Physician
  • Mansfield, TX
National Provider Identifier
1164405270
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
EMC0000656 Issued in MI
Practice address
2800 E Broad St Ste 421
Mansfield, TX 76063-6415
Phone
(469) 695-2028
Fax
(469) 695-2029
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MC-0787 ID
Surgery Physician 208600000X 219511 MA
Surgery Physician 208600000X MD23567 ME
Surgery Physician 208600000X 2006-01252 NC
Surgical Critical Care Physician 2086S0102X MD61612669 WA
Trauma Surgery Physician 2086S0127X V4068 TX
Trauma Surgery Physician 2086S0127X EMC0000656 MI Primary

Addresses

Primary practice location

2800 E Broad St Ste 421
Mansfield, TX 76063-6415

Mailing address

2800 E Broad St Ste 421
Mansfield, TX 76063-6415
Phone (469) 695-2028

Other practice location 1

22 Bramhall St
Portland, ME 04102-3175
Phone (207) 661-7075

Other practice location 2

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (284) 964-1187

Other practice location 3

999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone (208) 302-2600

Other practice location 4

93 Campus Ave I2 Wing
Lewiston, ME 04240-6030
Phone (207) 777-8650

Other practice location 5

888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 942-3627

Other identifiers 2

IdentifierTypeStateIssuer
2021536MedicaidMA
1431ROtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME, MI, TX4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20041201000941 MA Practitioner - General SurgeryPractitioner - Other (Physician) 5395701395 Reassigns benefits to 1 organization
I20200917000984 ME Practitioner - General Surgery 5395701395 Reassigns benefits to 1 organization
I20240430003527 MI Practitioner - General Surgery 5395701395 Reassigns benefits to 1 organization
I20250320000817 TX Practitioner - General Surgery 5395701395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

2800 E Broad St
Suite 421
Mansfield, TX 76063-6415
Phone (469) 695-2028

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MC-0787IDMDSurgery Physician
MD23567MEMDSurgery Physician
2006-01252NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of Cape Cod Hospital CurrentSince Jan 14, 2019 Accepting new patients
Beaumont Medical Group- Specialty Services Surgery CurrentSince Apr 9, 2024 Accepting new patients
Maine Medical Partners Surgery CurrentSince Nov 13, 2023 Accepting new patients
Maine Medical Partners Surgery Current Accepting new patients
Medhealth Trauma Surgery CurrentSince Jan 13, 2025 Accepting new patients
Medhealth CurrentSince Jan 13, 2025 Accepting new patients
Umass Memorial Medical Group Inc Surgery Past Accepting new patients
Saint Alphonsus Specialty Services Inc Surgery Past Accepting new patients

Locations

297 North St
Ste 221
Hyannis, MA 02601
Phone (508) 862-5032

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

2800 E Broad St
Ste 421
Mansfield, TX 76063
Phone (469) 695-2028

Interoperability endpoints

  • Direct secure messaging: mshapiro288686@ahs.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1164405270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 421",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636415",
            "telephone_number": "469-695-2028",
            "fax_number": "469-695-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 421",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636415",
            "telephone_number": "469-695-2028",
            "fax_number": "469-695-2029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023175",
            "country_code": "US",
            "telephone_number": "207-661-7075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "284-964-1187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N Curtis Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061334",
            "country_code": "US",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "93 Campus Ave I2 Wing",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "042406030",
            "country_code": "US",
            "telephone_number": "207-777-8650",
            "fax_number": "207-777-8641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Swift Blvd",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523514",
            "country_code": "US",
            "telephone_number": "509-942-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "MC-0787",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "219511",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD23567",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2006-01252",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WA",
            "license": "MD61612669",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "V4068",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MI",
            "license": "EMC0000656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021536",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1431R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.