Individual provider Active NPI

Alexander Shustorovich, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Edison, NJ
National Provider Identifier
1306372552
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
25MB11415000 Issued in NJ
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 321-7000
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 25MB11415000 NJ Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220901002049 NJ Practitioner - Pain ManagementPractitioner - Physical Medicine and Rehabilitation 2466700711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
HMH Hospitals Corporation CurrentSince Jul 1, 2022 Accepting new patients
HMH Hospitals Corporation CurrentSince Jul 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 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

65 James St
Lot G
Edison, NJ 08820
Phone (732) 321-7487

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

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

Interoperability endpoints

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

Organizations & group practices 5

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 4

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": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1306372552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        },
        {
            "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": "732-321-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTOROVICH",
        "first_name": "ALEXANDER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MB11415000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.