Shivani Khetani, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

25MA12757900 Issued in NJ

Practice address

22-18 Broadway Ste 201
Fair Lawn, NJ 07410-3016

Phone

(862) 297-9696

NPI assigned

Jun 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Endocrinology

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Medical Associates of Englewood, PC

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1952681918
  Medicare reassignment Care Compare group NPD
• Physician Partners of Englewood, PC

  • Internal Medicine Physician
  • Jersey City, NJ
  • NPI 1154671501
  NPD (past)

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

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1639793540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 MCBRIDE AVE",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074243812",
            "telephone_number": "973-812-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-18 BROADWAY STE 201",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103016",
            "telephone_number": "862-297-9696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 McBride Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland Park",
            "state": "NJ",
            "postal_code": "074243812",
            "country_code": "US",
            "telephone_number": "973-812-0377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHETANI",
        "first_name": "SHIVANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "UTRESIDENT",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA12757900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark L Khurgin, PT
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• Bethany Killian, CCC-SLP
• Dong Hyun Kim, OD

• Endocrinology, Diabetes & Metabolism Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; 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.