Mark Steven Shaffer, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

136330 Issued in NY

Practice address

69-36A 215 Street
Bayside, NY 11364

Phone

(718) 279-8787

Fax

(718) 279-8993

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295836674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69-36A 215 STREET",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-279-8787",
            "fax_number": "718-279-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69-36A 215 STREET",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-279-8787",
            "fax_number": "718-279-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "136330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00528969",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ashma Shahid
• Monna Shahna, LMSW
• Jing Shan, P.T.

• Internal Medicine Physician in Bayside, NY
• Providers in Bayside, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.