Individual provider Active NPI

Benjamin Shaw, P.A

  • Medical Physician Assistant
  • South Bound Brook, NJ
National Provider Identifier
1477986610
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00306300 Issued in NJ
Practice address
141 Main St
South Bound Brook, NJ 08880-1480
Phone
(732) 560-1234
NPI assigned
Aug 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00306300 NJ Primary

Addresses

Primary practice location

141 Main St
South Bound Brook, NJ 08880-1480

Mailing address

141 Main St
South Bound Brook, NJ 08880-1480
Phone (732) 560-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140127000013 NJ Practitioner - Physician Assistant 9638307424 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

141 Main St
Suite 1
South Bound Brook, NJ 08880-1480
Phone (615) 972-9119

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Feb 17, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Feb 17, 2024 Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

141 Main St
Ste 1
South Bound Brook, NJ 08880
Phone (732) 560-1234

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Interoperability endpoints

  • Direct secure messaging: bshaw15081@epicdirect.rwjbh.org

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": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1477986610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MAIN ST",
            "city": "SOUTH BOUND BROOK",
            "state": "NJ",
            "postal_code": "088801480",
            "telephone_number": "732-560-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MAIN ST",
            "city": "SOUTH BOUND BROOK",
            "state": "NJ",
            "postal_code": "088801480",
            "telephone_number": "732-560-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BENJAMIN",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-12",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00306300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bound Brook, NJ

Sources for this page

Verify at the official NPI Registry.