Individual provider Active NPI

David J Shulkin, MD

  • Internal Medicine Physician
  • Morristown, NJ
National Provider Identifier
1225012883
Registry record updated Feb 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236955 Issued in NY
Practice address
100 Madison Ave
Morristown, NJ 07960-6136
Phone
(973) 971-5450
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD039174E PA
Internal Medicine Physician 207R00000X 236955 NY Primary

Addresses

Primary practice location

100 Madison Ave
Morristown, NJ 07960-6136

Mailing address

944 Merion Square Rd
Gladwyne, PA 19035-1510
Phone (610) 453-0362

Other practice location 1

230 W 17th St
New York, NY 10011-5325
Phone (212) 206-5200

Other identifiers 2

IdentifierTypeStateIssuer
183127U77OtherNJMEDICARE
5547407MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236955NYMDLicensed Practical Nurse
MD039174EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merion Square Road Medical PC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Merion Square Road Medical P.C. Current Accepting new patients
Global Pain Center Inc Internal Medicine Current Accepting new patients
Sanford Medical Center Fargo PastSince Jan 1, 2024 Accepting new patients
Medminder Systems Inc PastSince Mar 8, 2021 Accepting new patients
Beth Israel Medical Center Internal Medicine Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Sanford Bismarck PastSince Jan 1, 2024 Accepting new patients
Marshfield Clinic Inc PastSince Jan 1, 2025 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Sanford Clinic PastSince Jan 1, 2024 Accepting new patients

Organizations & group practices 11

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550361600000",
    "number": "1225012883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 MERION SQUARE RD",
            "city": "GLADWYNE",
            "state": "PA",
            "postal_code": "190351510",
            "telephone_number": "610-453-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "973-971-5450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 W 17th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100115325",
            "country_code": "US",
            "telephone_number": "212-206-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULKIN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2019-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD039174E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "183127U77",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5547407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.