Individual provider Active NPI

Philip Edwin Shapiro, MD

  • Dermatopathology (Pathology) Physician
  • Meriden, CT
National Provider Identifier
1477561389
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
029159 Issued in CT
Practice address
140 Green Road
Meriden, CT 06450
Phone
(203) 630-2245
Fax
(203) 630-2909
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 029159 CT
Dermatopathology (Pathology) Physician 207ZD0900X 029159 CT Primary

Addresses

Primary practice location

140 Green Road
Meriden, CT 06450

Mailing address

140 Green Road
Meriden, CT 06450
Phone (203) 630-2245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20101011000128 CT Practitioner - Dermatology 3577528975 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopathology Laboratory of New England PC Dermatology CurrentSince Jul 26, 1995 Accepting new patients

Locations

140 Green Rd
Meriden, CT 06450
Phone (203) 630-2245

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477561389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GREEN ROAD",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-630-2245",
            "fax_number": "203-630-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GREEN ROAD",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-630-2245",
            "fax_number": "203-630-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "PHILIP",
        "middle_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "029159",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CT",
            "license": "029159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.