Active NPI
Christopher Michael Shutty, D.O.
- Cytopathology Physician
- Brooklyn, NY
National Provider Identifier
1265668776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cytopathology Physician
- License
- 257416
- Practice address
- 904 49TH St
Brooklyn, NY 11219-2922 - Phone
- (718) 853-6433
- Fax
- (718) 853-6449
- NPI assigned
- Jun 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 229422 | MA | |
| Cytopathology Physician | 207ZC0500X | 257416 | NY | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 257416 | NY |
Addresses
Primary practice location
904 49TH St
Brooklyn, NY 11219-2922
Mailing address
1125 Banner Ave
Apt. 10C
Brooklyn, NY 11235-5260
Phone (718) 853-6433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 257416 | NY | MD | Cytopathology Physician |
| 229422 | MA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minkowitz Pathology | Cytopathology | Current | Accepting new patients |
Locations
904 49th St
Brooklyn, NY 11219
Phone (718) 850-6433
Organizations & group practices 1
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": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1265668776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 BANNER AVE",
"address_2": "APT. 10C",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112355260",
"telephone_number": "718-853-6433",
"fax_number": "718-853-6449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 49TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192922",
"telephone_number": "718-853-6433",
"fax_number": "718-853-6449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUTTY",
"first_name": "CHRISTOPHER",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-10",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MA",
"license": "229422",
"primary": false
},
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "NY",
"license": "257416",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NY",
"license": "257416",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.