Stefanie Shore, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ14864500 Issued in NJ

Practice address

246 Hamburg Tpke Ste 207
Wayne, NJ 07470-2160

Phone

(973) 653-3366

Fax

(973) 653-3365

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Jersey Nephrology Assoc. PAGroup PAC ID 7315908167, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stefanie.shore@direct.davitaphysiciansolutions.com

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.

• North Jersey Nephrology Assoc. PA

  • Nephrology Physician
  • Wayne, NJ
  • NPI 1801906896
  Medicare reassignment Care Compare group NPD

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

• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1649964446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE STE 207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702160",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE STE 207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702160",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "STEFANIE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14864500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nivine Tanios Shenouda, PH.D.
• Michael Kenneth Shindle, MD
• Robert David Shlien, MD
• Shoes to You
• Nancy Shora
• Erin Kathleen Short
• Arkadiy Shraytman, D.O.
• Prayank Shrestha, DPM
• Hervey Silas Sicherman, MD
• Imtiazuddin M Siddiqui, MD

• Nurse Practitioner in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.