Individual provider Active NPI

Michael Adam Shapiro, MD

  • Child & Adolescent Psychiatry Physician
  • Norfolk, VA
National Provider Identifier
1417118977
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
0101279246 Issued in VA
Practice address
850 Southampton Ave
Norfolk, VA 23510-1021
Phone
(757) 668-4673
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 12183 FL
Child & Adolescent Psychiatry Physician 2084P0804X ME109521 FL
Child & Adolescent Psychiatry Physician 2084P0804X 0101279246 VA Primary

Addresses

Primary practice location

850 Southampton Ave
Norfolk, VA 23510-1021

Mailing address

850 Southampton Ave
Norfolk, VA 23510-1021
Phone (757) 668-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 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

Enrollment IDStateProvider typePAC IDDetails
I20130524000319 FL Practitioner - Psychiatry 0840438271 Reassigns benefits to 1 organization
I20240328002121 VA Practitioner - Psychiatry 0840438271 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12183FLMDRegistered Dietitian
ME109521FLMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2013 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2013 Accepting new patients
Childrens Specialty Group PLLC CurrentSince Feb 10, 2024 Accepting new patients
Family Preservation Services Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

1924 Landstown Centre Way
Virginia Beach, VA 23456
Phone (757) 668-4673

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1417118977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SOUTHAMPTON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101021",
            "telephone_number": "757-668-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SOUTHAMPTON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101021",
            "telephone_number": "757-668-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "12183",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME109521",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101279246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.