Individual provider Active NPI

Leah Shaffren, PA

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1639428030
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0153691 Issued in NY
Practice address
3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone
(718) 951-2955
NPI assigned
Aug 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0153691 NY Primary

Addresses

Primary practice location

3201 Kings Hwy
Brooklyn, NY 11234-2625

Mailing address

1030 E 28TH St
Brooklyn, NY 11210-3742
Phone (718) 377-0394

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160119002337 NJ Practitioner - Physician Assistant 1355644782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1771 Madison Ave
Lakewood, NJ 08701-1242
Phone (732) 364-2144

1771 Madison Ave
Lakewood, NJ 08701-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0153691NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center, Inc. CurrentSince Oct 20, 2015 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Oct 20, 2015 Accepting new patients
Lakewood Resource and Referral Center Inc Past Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Interoperability endpoints

  • Direct secure messaging: leah.shaffren@chemed.eclinicaldirectplus.com

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": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1639428030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E 28TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103742",
            "telephone_number": "718-377-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342625",
            "telephone_number": "718-951-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFREN",
        "first_name": "LEAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "0153691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.