Individual provider Active NPI

Liliya Shaporova, P.A. -C

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1255588125
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00525100 Issued in NJ
Practice address
585 Schenectady Ave
Brooklyn, NY 11203-1809
Phone
(718) 604-5421
Fax
(718) 604-5527
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 012103 NY
Surgical Physician Assistant 363AS0400X 25MP00525100 NJ Primary

Addresses

Primary practice location

585 Schenectady Ave
Brooklyn, NY 11203-1809

Mailing address

585 Schenectady Ave
Managed Care Dept. - Blumberg BLDG 6TH Floor
Brooklyn, NY 11203-1809
Phone (718) 604-5469

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
I20240328001356 NJ Practitioner - Physician Assistant 5698842466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

475 Hwy 70
Suite 101
Lakewood, NJ 08701-5897
Phone (732) 364-8000

99 Hwy 37 W
Toms River, NJ 08755-6423
Phone (732) 477-8988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012103NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Feb 18, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Feb 18, 2024 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients
Twenty First Century Urology PLLC Past Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Organizations & group practices 4

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1255588125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "address_2": "MANAGED CARE DEPT. - BLUMBERG BLDG 6TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031809",
            "telephone_number": "718-604-5469",
            "fax_number": "718-604-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031809",
            "telephone_number": "718-604-5421",
            "fax_number": "718-604-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPOROVA",
        "first_name": "LILIYA",
        "credential": "P.A. -C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "012103",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00525100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.