NPIMap

Individual provider Active NPI

Mark L Shapiro, MD

  • Diagnostic Radiology Physician
  • Englewood, NJ
National Provider Identifier
1447215710
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MA60585 Issued in NJ
Practice address
350 Engle St
Englewood Hospital & Medical Center
Englewood, NJ 07631
Phone
(201) 894-3400
Fax
(201) 894-5244
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MA60585 NJ Primary

Addresses

Primary practice location

350 Engle St
Englewood Hospital & Medical Center
Englewood, NJ 07631

Mailing address

350 Engle St
Englewood, NJ 07631
Phone (201) 894-3400

Other identifiers 1

IdentifierTypeStateIssuer
6814701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720000053 NJ Practitioner - Diagnostic Radiology 2860429073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Englewood Radiologic Group P aGroup PAC ID 6901852300, 131 clinicians

Practice addresses (Care Compare)

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 894-3480

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
  • Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA60585NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince Jul 21, 1994 Accepting new patients
Advanced Medical Imaging of North Jersey, LLC Diagnostic Radiology PastSince Jul 1, 2009 Accepting new patients

Locations

452 Old Hook Rd
Ste 301
Emerson, NJ 07630

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

350 Engle St
Rm 145402
Englewood, NJ 07631

Organizations & group practices 2

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 7

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1447215710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-894-3400",
            "fax_number": "201-894-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "address_2": "ENGLEWOOD HOSPITAL & MEDICAL CENTER",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-894-3400",
            "fax_number": "201-894-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "MA60585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6814701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.