Individual provider Active NPI

Berett Paige Shaps, M.D.

  • Pediatrics Physician
  • Smithtown, NY
National Provider Identifier
1710215215
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
254837 Issued in NY
Practice address
300 E Main St
Smithtown, NY 11787-2900
Phone
(631) 979-6466
Fax
(631) 979-6475
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 49318 CT
Pediatrics Physician 208000000X 254837 NY Primary

Addresses

Primary practice location

300 E Main St
Smithtown, NY 11787-2900

Mailing address

300 E Main St Ste 5
Smithtown, NY 11787-2900
Phone (631) 979-6466

Other identifiers 1

IdentifierTypeStateIssuer
008033892MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100209000394 NY Practitioner - Pediatric Medicine 2264575547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49318CTMDPediatrics Physician
254837NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Oct 1, 2014 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Oct 1, 2014 Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

300 E Main St
Ste 4
Smithtown, NY 11787

300 E Middle Country Rd
Smithtown, NY 11787
Phone (631) 265-3727

300 E Main St
Ste 5
Smithtown, NY 11787
Phone (631) 979-6466

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: berett.shaps.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 2

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": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1710215215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST STE 5",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-979-6466",
            "fax_number": "631-979-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-979-6466",
            "fax_number": "631-979-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPS",
        "first_name": "BERETT",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "49318",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "254837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008033892",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.