John A Shivdat, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MB06152500 Issued in NJ

Practice address

1120 Morningside Dr
Perry, GA 31069-2906

Phone

(478) 988-1706

Fax

(478) 988-1794

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, NJ2 enrollments

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 2

Specialty

Emergency Medicine

Education

Rowan University School of Osteopathic Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middlesex Emergency Physicians, P.a.Group PAC ID 9931002854, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Merit-based Incentive Payment System (MIPS)

Final score

86.03 of 100Reported as group

Quality

79.32

Improvement activities

40

Cost

54.54

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 Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14489/brand/1/csg/1/fhir/r4

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.

• Middlesex Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Edison, NJ
  • NPI 1811921760
  Medicare reassignment Care Compare group NPD
• Home Physician Care, LLC

  • General Practice Physician
  • Buford, GA
  • NPI 1003047184

  Emergency Medicine

  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• Plainfield Emergency Physicians, PA

  • Emergency Medicine Physician
  • Plainfield, NJ
  • NPI 1659309680
  Medicare reassignment NPD
• Georgia Em-I Medical Services, LLC

  • Nurse Practitioner
  • Covington, GA
  • NPI 1255213005

  Emergency Medicine

  NPD (past)
• Houston Emergency Physicians LLC

  • Emergency Medicine Physician
  • Warner Robins, GA
  • NPI 1558319947
  NPD (past)
• Morningside Emergency Physicians LLC

  • Emergency Medicine Physician
  • Perry, GA
  • NPI 1114975521
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1376599746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 GRAND OAKS GLN NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645423",
            "telephone_number": "770-424-0901",
            "fax_number": "727-507-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MORNINGSIDE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692906",
            "telephone_number": "478-988-1706",
            "fax_number": "478-988-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVDAT",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "47527",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB06152500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6848109",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00630321",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Christine Sanders, SLP
• Sapp'S Physical Therapy Services, Inc.
• Tori L Scott, LMT
• Amin M Shehadeh, MD
• Louis C Shelton
• Shriver Management Group Inc
• Shriver Management Group Inc
• Spencer D Shugart, MPT
• Megan Simmons
• Lauren M Simpson

• Emergency Medicine Physician in Perry, GA
• Providers in Perry, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.