Active NPI
David Shansky, D.P.M.
- Primary Podiatric Medicine Podiatrist
- East Brunswick, NJ
National Provider Identifier
1528052354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- MD001172
- Practice address
- 11 Colonial Dr
East Brunswick, NJ 08816-2714 - Phone
- (732) 589-8631
- Fax
- (732) 238-7928
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | MD001172 | NJ | Primary |
Addresses
Primary practice location
11 Colonial Dr
East Brunswick, NJ 08816-2714
Mailing address
11 Colonial Dr
East Brunswick, NJ 08816-2714
Phone (732) 589-8631
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AMERIGROUP | Other | NJ | 295675 |
| 065907 | Medicaid | NJ | |
| HEALTHNET | Other | NJ | 3K2937 |
| UNIVERSITY HEALTH PL | Other | NJ | 36337 |
| AMERICHOICE | Other | NJ | 91001491602 |
| OXFORD | Other | NJ | P3474563 |
| 222345167 | Other | NJ | HORIZON BC/BS |
| CIGNA | Other | NJ | 5456004 |
| UNITED HEALTH CARE | Other | NJ | 222345167 |
| HORIZON NJ HEALTH | Other | NJ | 1123189 |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100909000316 | NJ | Practitioner - Podiatry | 1759406119 | Practice locations: East Brunswick, NJ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD001172 | NJ | MD | Primary Podiatric Medicine Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585872000000",
"number": "1528052354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 COLONIAL DR",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088162714",
"telephone_number": "732-589-8631",
"fax_number": "732-238-7928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 COLONIAL DR",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088162714",
"telephone_number": "732-589-8631",
"fax_number": "732-238-7928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANSKY",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NJ",
"license": "MD001172",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "295675",
"identifier": "AMERIGROUP",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "065907",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "3K2937",
"identifier": "HEALTHNET",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "36337",
"identifier": "UNIVERSITY HEALTH PL",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "91001491602",
"identifier": "AMERICHOICE",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "P3474563",
"identifier": "OXFORD",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON BC/BS",
"identifier": "222345167",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "5456004",
"identifier": "CIGNA",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "222345167",
"identifier": "UNITED HEALTH CARE",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1123189",
"identifier": "HORIZON NJ HEALTH",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.