Individual provider Active NPI

Alan Marc Shaiman, MD

  • Therapeutic Radiology Physician
  • Jersey City, NJ
National Provider Identifier
1619065059
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
25MA04012200 Issued in NJ
Practice address
631 Grand St
Jersey City Radiation Oncology
Jersey City, NJ 07304-3451
Phone
(201) 942-3999
Fax
(201) 942-3998
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X 25MA04012200 NJ Primary

Addresses

Primary practice location

631 Grand St
Jersey City Radiation Oncology
Jersey City, NJ 07304-3451

Mailing address

111 Yantacaw Brook Rd
Montclair, NJ 07043-2524
Phone (201) 942-3999

Other identifiers 1

IdentifierTypeStateIssuer
1289403MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050713000097 NJ Practitioner - Radiation Oncology 5991790982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1980
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)

631 Grand St
Jersey City, NJ 07304-3451
Phone (201) 942-3999

Hospital & facility affiliations

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group LLC CurrentSince Aug 21, 2012 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Aug 21, 2012 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Apr 29, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Apr 29, 2023 Accepting new patients
Radiology Professional Association Past Accepting new patients

Locations

85 Harristown Rd
Ste 200
Glen Rock, NJ 07452
Phone (201) 444-4526

631 Grand St
Jersey City, NJ 07304
Phone (201) 830-2280

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

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

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

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1619065059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 YANTACAW BROOK RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070432524",
            "telephone_number": "201-942-3999",
            "fax_number": "201-942-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 GRAND ST",
            "address_2": "JERSEY CITY RADIATION ONCOLOGY",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073043451",
            "telephone_number": "201-942-3999",
            "fax_number": "201-942-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIMAN",
        "first_name": "ALAN",
        "middle_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NJ",
            "license": "25MA04012200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1289403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.