Individual provider Active NPI

Shaghayegh Moghaddam Denoble, M.D.

  • Obstetrics & Gynecology Physician
  • Wayne, NJ
National Provider Identifier
1770726564
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA08748500 Issued in NJ
Practice address
2025 Hamburg Tpke Ste C
Wayne, NJ 07470-6250
Phone
(019) 577-2202
Fax
(201) 977-6747
NPI assigned
Apr 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA08748500 NJ Primary

Addresses

Primary practice location

2025 Hamburg Tpke Ste C
Wayne, NJ 07470-6250

Mailing address

2025 Hamburg Tpke Ste C
Wayne, NJ 07470-6250
Phone (201) 957-7220

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100903000180 NJ Practitioner - Obstetrics/Gynecology 4587788179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Massachusetts Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Health Partners 28 clinicians

Practice addresses (Care Compare)

333 Route 46 W
Suite 106
Mountain Lakes, NJ 07046-1743
Phone (973) 829-7965

Hospital & facility affiliations

  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

Merit-based Incentive Payment System (MIPS)

Final score
78.32 of 100Reported as group
Quality
62.32
Promoting interoperability
100
Improvement activities
40
Cost
65.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08748500NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Health Partners CurrentSince Sep 1, 2023 Accepting new patients
Atlantic Health Partners CurrentSince Sep 1, 2023 Accepting new patients
Physicians for Women, PA Obstetrics & Gynecology Past Accepting new patients

Locations

333 US Highway 46
Ste 106
Mountain Lks, NJ 07046
Phone (973) 829-7965

Interoperability endpoints

  • Direct secure messaging: sdenoble53089@direct.ahsys.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1770726564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 HAMBURG TPKE STE C",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706250",
            "telephone_number": "201-957-7220",
            "fax_number": "201-977-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 HAMBURG TPKE STE C",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706250",
            "telephone_number": "019-577-2202",
            "fax_number": "201-977-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENOBLE",
        "first_name": "SHAGHAYEGH",
        "middle_name": "MOGHADDAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08748500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.