Active NPI
David J Shulkin, MD
- Internal Medicine Physician
- Morristown, NJ
National Provider Identifier
1225012883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 236955
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183127U77 | Other | NJ | MEDICARE |
| 5547407 | Medicaid | NJ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 236955 | NY | MD | Licensed Practical Nurse |
| MD039174E | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merion Square Road Medical PC | Internal Medicine | Current | 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 | Past | Accepting new patients | |
| Medminder Systems Inc | Past | Accepting new patients | |
| Beth Israel Medical Center | Internal Medicine | Past | Accepting new patients |
| Bimc Faculty Practice | Past | Accepting new patients | |
| Sanford Bismarck | Past | Accepting new patients | |
| Marshfield Clinic Inc | Past | Accepting new patients | |
| Bimc Faculty Practice | Past | Accepting new patients | |
| Sanford Clinic | Past | 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.
-
- Adult Mental Health Clinic/Center
- Dayton, OH
- NPI 1457037921
-
- Internal Medicine Physician
- New York, NY
- NPI 1861457202
-
- Sports Medicine (Orthopaedic Surgery) Physician
- New York, NY
- NPI 1093906828
-
- Neurology Physician
- New York, NY
- NPI 1891848461
-
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
-
- Community/Retail Pharmacy
- Norwood, MA
- NPI 1073985941
-
- Multi-Specialty Clinic/Center
- Bismarck, ND
- NPI 1811941172
-
- Diagnostic Radiology Physician
- Fargo, ND
- NPI 1306641345
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
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.