NPIMap

Individual provider Active NPI

Kyle Shaw

  • Podiatrist
  • Williamstown, NJ
National Provider Identifier
1710410899
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00355700 Issued in NJ
Practice address
364 Berlin Cross Keys Rd
Williamstown, NJ 08094-3473
Phone
(856) 994-0004
Fax
(856) 497-5133
NPI assigned
Apr 6, 2017
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00355700 NJ Primary
Podiatrist 213E00000X SC007080 PA

Addresses

Primary practice location

364 Berlin Cross Keys Rd
Williamstown, NJ 08094-3473

Mailing address

134 Bridgeton Pike Ste C
Mullica Hill, NJ 08062-2616
Phone (856) 507-2783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200722000024 NJ Practitioner - Podiatry 0446674683 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

364 Berlin Cross Keys Rd
Williamstown, NJ 08094-3473
Phone (856) 885-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue197
Removal of skin lesions12
Removal of nail tissue136
Removal or shaving of skin growth55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mullica Hill Podiatry Associates PA Podiatrist CurrentSince Jul 1, 2020 Accepting new patients
Dr. Christopher M Larosa LLC CurrentSince Apr 1, 2022 Accepting new patients
Melrose Podiatry Associates, Inc. Podiatrist CurrentSince Aug 1, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Nov 7, 2025 Accepting new patients
Highland Park Podiatry,PC Podiatrist CurrentSince Aug 1, 2020 Accepting new patients
Inspira Health Network Medical Group, P.C. CurrentSince Apr 8, 2024 Accepting new patients

Locations

146 S Lakeview Dr
Ste 101
Gibbsboro, NJ 08026
Phone (856) 435-4002

155 Bridgeton Pike
Ste B
Mullica Hill, NJ 08062
Phone (856) 845-4061

53 S Main St
Mullica Hill, NJ 08062
Phone (856) 223-0227

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

364 Berlin Cross Keys Rd
Williamstown, NJ 08094
Phone (856) 885-2600

1520 Snyder Ave
Philadelphia, PA 19145
Phone (215) 462-2610

8011 W Chester Pike
Upper Darby, PA 19082
Phone (610) 449-2345

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1710410899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BRIDGETON PIKE STE C",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622616",
            "telephone_number": "856-507-2783",
            "fax_number": "856-221-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 BERLIN CROSS KEYS RD",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080943473",
            "telephone_number": "856-994-0004",
            "fax_number": "856-497-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00355700",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC007080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, NJ

Sources for this page

Verify at the official NPI Registry.