Individual provider Active NPI

Taylor Shaker, M.D, M.S.

  • Family Medicine Physician
  • Oakland, NJ
National Provider Identifier
1215390083
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10249600 Issued in NJ
Practice address
43 Yawpo Ave
Oakland, NJ 07436-2714
Phone
(201) 337-9600
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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 NJ
Family Medicine Physician 207Q00000X 25MA10249600 NJ Primary

Addresses

Primary practice location

43 Yawpo Ave
Oakland, NJ 07436-2714

Mailing address

43 Yawpo Ave
Oakland, NJ 07436-2714
Phone (201) 337-9600

Other practice location 1

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180912001943 NJ Practitioner - Family Practice 1658621602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

155 Polifly Rd
Hackensack, NJ 07601-1758
Phone (201) 343-6364

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10249600NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Aug 1, 2018 Accepting new patients
Excelcare Medical Associates, PA Family Medicine CurrentSince Jun 1, 2025 Accepting new patients

Locations

341 Broad St
Ste A
Clifton, NJ 07013

155 Polifly Rd
Hackensack, NJ 07601
Phone (201) 343-6360

3 University Plz
Ste 205
Hackensack, NJ 07601

43 Yawpo Ave
Oakland, NJ 07436
Phone (201) 337-0066

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

Organizations & group practices 2

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1215390083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 YAWPO AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362714",
            "telephone_number": "201-337-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 YAWPO AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362714",
            "telephone_number": "201-337-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Rehill Ave",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "NJ",
            "postal_code": "088762519",
            "country_code": "US",
            "telephone_number": "908-685-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKER",
        "first_name": "TAYLOR",
        "credential": "M.D, M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10249600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, NJ

Sources for this page

Verify at the official NPI Registry.