Individual provider Active NPI

Mikhail Shapiro, DO

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1417049123
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
209819 Issued in NY
Practice address
2583 Ocean Ave
Brooklyn, NY 11229-4552
Phone
(718) 648-1111
Fax
(718) 648-5700
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 209819 NY Primary

Addresses

Primary practice location

2583 Ocean Ave
Brooklyn, NY 11229-4552

Mailing address

16 Lamoka Ave
Staten Island, NY 10308-2025
Phone (718) 648-1111

Other identifiers 1

IdentifierTypeStateIssuer
01897194MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000418 NY Practitioner - Physical Medicine and RehabilitationPractitioner - Geriatric Medicine 7911991377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Geriatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1811 Hone Ave
Bronx, NY 10461-1406
Phone (718) 518-1133

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209819NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Concept Rehabilitation Medicine PC CurrentSince Mar 1, 2005 Accepting new patients
Dr.Shapiro Excel Rehabilitation PC Physical Medicine & Rehabilitation Past Accepting new patients
Queens Boulevard Extended Care Facility Management LLC Past Accepting new patients
Intermed Care PC Past Accepting new patients
Healthpoint Medical Group, LLC Past Accepting new patients

Locations

3895 Route 516
Ste 2B
Old Bridge, NJ 08857
Phone (732) 679-4500

3155 Grace Ave
Bronx, NY 10469
Phone (718) 304-2866

1811 Hone Ave
Bronx, NY 10461
Phone (516) 499-9016

3035 W 24th St
Brooklyn, NY 11224
Phone (347) 348-1518

2865 Brighton 3rd St
Brooklyn, NY 11235
Phone (718) 645-1118

18515 HL Side Ave
Jamaica, NY 11432
Phone (718) 262-8651

18515 HL Side Ave
Jamaica, NY 11432
Phone (718) 262-8651

6111 Queens Blvd
Woodside, NY 11377
Phone (718) 205-0287

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21268/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mikhail.shapiro.1@21268.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1417049123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 LAMOKA AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082025",
            "telephone_number": "718-648-1111",
            "fax_number": "718-648-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2583 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "718-648-1111",
            "fax_number": "718-648-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MIKHAIL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "209819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01897194",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.