Individual provider Active NPI

Michael Shapiro, PH.D.

  • Psychologist
  • Charlottesville, VA
National Provider Identifier
1508115668
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810005975 Issued in VA
Practice address
812 E High St
Charlottesville, VA 22902-5126
Phone
(434) 542-8421
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Psychologist 103T00000X PS017314 PA
Clinical Psychologist 103TC0700X P3385 TN
Psychologist 103T00000X 0810005975 VA Primary

Addresses

Primary practice location

812 E High St
Charlottesville, VA 22902-5126

Mailing address

1516 Rutledge Ave
Charlottesville, VA 22903-1418
Phone (847) 323-9510

Other practice location 1

4219 Hillsboro Pike Ste 306
Nashville, TN 37215-3332
Phone (615) 454-6502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313000016 VA Practitioner - Clinical Psychologist 7315192408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Momentous Health IncGroup PAC ID 4082060330, 5 clinicians

Practice addresses (Care Compare)

Charlottesville, VA 22902
Phone (800) 679-1730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS017314PAMDPsychologist
PS017315PAMDPsychologist
P3385TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentous Health Inc CurrentSince Apr 16, 2025 Accepting new patients
Neuropsychology Consultants, PLLC Clinical Neuropsychologist PastSince May 11, 2017 Accepting new patients

Locations

812 E High St
Charlottesville, VA 22902
Phone (434) 542-8421

Organizations & group practices 3

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": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1508115668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 RUTLEDGE AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229031418",
            "telephone_number": "847-323-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E HIGH ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025126",
            "telephone_number": "434-542-8421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4219 Hillsboro Pike Ste 306",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372153332",
            "country_code": "US",
            "telephone_number": "615-454-6502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017314",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P3385",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810005975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.