Max Shutran, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

75465 Issued in CT

Practice address

29 Hospital PLZ Ste 602
Stamford, CT 06902-3602

Phone

(203) 276-4884

Fax

(203) 276-8418

NPI assigned

May 29, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CT2 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

Specialty

Neurology

Education

Tufts University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stamford Health Medical Group IncGroup PAC ID 6901099746, 442 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stamford Hospital Hospital, Stamford, CT, CCN 070006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: mshutran24629@stamfordhealth.direct-ci.com
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://fhir4.healow.com/fhir/r4/ABCIBA

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.

• Stamford Health Medical Group Inc

  • General Practice Physician
  • Stamford, CT
  • NPI 1154633980
  Medicare reassignment Care Compare group NPD
• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Anesthesiology Physician
  • New York, NY
  • NPI 1477068971
  NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• Neurosurgical Associates, P.C.

  • Specialist
  • New York, NY
  • NPI 1407804008
  NPD (past)
• New England Medical Center Group Practice Inc

  • Neurological Surgery Physician
  • Boston, MA
  • NPI 1487601787
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Stamford Hospital

  • General Acute Care Hospital
  • Stamford, CT
  • NPI 1356331425
  Care Compare affiliation

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1508278227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL PLZ STE 602",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-4884",
            "fax_number": "203-276-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL PLZ STE 602",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-276-4884",
            "fax_number": "203-276-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTRAN",
        "first_name": "MAX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "323908",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CT",
            "license": "75465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shippan Dental Center
• Lisa Shklovsky
• Shoreline Medical, LLP
• Farhaad Shroff
• Edward Shukovsky, DMD
• Ronnie Ness Sichel, MS, CAGS, CCC-SLP
• Steven Milton Sichel, PHD
• Aisha Siddiqi, M.D.
• Ayesha Siddiqui, M.S.
• Elizabeth Siderides, M.D.

• Neurological Surgery Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Neurological Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.