NPIMap

Individual provider Active NPI

Robert P Shavelson, M.D.

  • Internal Medicine Physician
  • Tinton Falls, NJ
National Provider Identifier
1730173584
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA51725 Issued in NJ
Practice address
4057 Asbury Ave
Tinton Falls, NJ 07753-7700
Phone
(732) 922-1222
Fax
(732) 922-7708
NPI assigned
Sep 8, 2005
Last updated
May 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA51725 NJ Primary

Addresses

Primary practice location

4057 Asbury Ave
Tinton Falls, NJ 07753-7700

Mailing address

4057 Asbury Ave
Tinton Falls, NJ 07753-7700
Phone (732) 922-1222

Other identifiers 1

IdentifierTypeStateIssuer
0566209MedicaidNJ

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
I20050623000223 NJ Practitioner - Internal Medicine 7416992144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

4057 Asbury Ave
Tinton Falls, NJ 07753-7700
Phone (732) 922-1222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA51725NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Jersey Shore Tinton Falls Medical Associates, P.C. Internal Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

4001 Asbury Ave
Tinton Falls, NJ 07753
Phone (732) 922-1222

4057 Asbury Ave
Tinton Falls, NJ 07753
Phone (732) 493-0669

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • Direct secure messaging: robert.shavelson@direct.hackensackmeridian.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1730173584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 ASBURY AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537700",
            "telephone_number": "732-922-1222",
            "fax_number": "732-922-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 ASBURY AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077537700",
            "telephone_number": "732-922-1222",
            "fax_number": "732-922-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAVELSON",
        "first_name": "ROBERT",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA51725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0566209",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

Verify at the official NPI Registry.