Individual provider Active NPI

Shafiqa Popal

  • Adult Health Clinical Nurse Specialist
  • Edison, NJ
National Provider Identifier
1245679869
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
NP23130 Issued in CA
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 321-7010
Fax
(732) 654-1584
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 26NJ15002200 NJ
Adult Health Clinical Nurse Specialist 364SA2200X NP23130 CA Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

3801 Miranda Ave
Palo Alto, CA 94304-1207
Phone (650) 493-5000

Other practice location 2

1180 Raritan Rd
Clark, NJ 07066-1311
Phone (732) 321-7010

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241003001547 NJ Practitioner - Nurse Practitioner 8022549872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7189

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP23130CAMDAdult Health Clinical Nurse Specialist
26NJ15002200NJMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 20, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 20, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

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 2

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": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1245679869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7010",
            "fax_number": "732-654-1584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Miranda Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041207",
            "country_code": "US",
            "telephone_number": "650-493-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1180 Raritan Rd",
            "address_purpose": "LOCATION",
            "city": "Clark",
            "state": "NJ",
            "postal_code": "070661311",
            "country_code": "US",
            "telephone_number": "732-321-7010",
            "fax_number": "732-744-5827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPAL",
        "first_name": "SHAFIQA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NJ",
            "license": "26NJ15002200",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "CA",
            "license": "NP23130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.