Individual provider Active NPI

David Shapiro, M.D.

  • Surgery Physician
  • Evergreen Park, IL
National Provider Identifier
1528084696
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036070700 Issued in IL
Practice address
9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone
(708) 422-7715
Fax
(708) 422-7816
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036070700 IL Primary

Addresses

Primary practice location

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441

Mailing address

3925 Lyons St
Evanston, IL 60203-1324

Other identifiers 1

IdentifierTypeStateIssuer
036070700MedicaidIL

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address swnamd@directaddress.net Direct Southwest Nephrology Associates, S.C.
Direct Messaging Address dshapiro276315@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shapiro Surgical Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dshapiro276315@direct.myadvocateaurora.org

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1528084696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 LYONS ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602031324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051441",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036070700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070700",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swnamd@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Southwest Nephrology Associates, S.C.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12205 S Cicero Ave",
            "address_2": "112",
            "city": "Alsip",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608032946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshapiro276315@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.