Robin Leslie Shore, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MB06022000 Issued in NJ

Practice address

223 N Van Dien Avenue
The Valley Hospital
Ridgewood, NJ 07450

Phone

(201) 444-2019

Fax

(201) 444-3604

NPI assigned

May 8, 2006

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

Other identifiers 1

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

Emergency Medicine

Education

Nova Southeastern College of Osteo Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rshore190237@ahs.direct-ci.com
• Direct secure messaging: robin.shore.1@2983.direct.athenahealth.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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Emergency Medical Associates of New Jersey PA

  • Emergency Medicine Physician
  • Long Branch, NJ
  • NPI 1841456068
  NPD (past)
• Rahway Emergency Medical Associates, LLC

  • Emergency Medicine Physician
  • Rahway, NJ
  • NPI 1891026217
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1689623670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1173",
            "address_2": "VALLEY EMERGENCY ROOM ASSOCIATES PA",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07451",
            "telephone_number": "800-777-2455",
            "fax_number": "610-617-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N VAN DIEN AVENUE",
            "address_2": "THE VALLEY HOSPITAL",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-444-2019",
            "fax_number": "201-444-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "ROBIN",
        "middle_name": "LESLIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB06022000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6931405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tuti Fareen Sheiban, MD
• Leo Tsing Shen, D.M.D.
• Tingliang Shen, M.D.
• Thomas Sherlock, DDS
• Max Jacob Sherman, PA-C
• Apexa Nilesh Shukla, MD
• Tina Sichrovsky, M.D.
• Nermin Sihly, MD
• Frank Joseph Sileo, PH.D.
• Jennifer Ruth Siller, DMD

• Emergency Medicine Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.