Active NPI
Mark Shapiro, CRNA, DNP, ACAGNP
- Acute Care Nurse Practitioner
- Bay Shore, NY
National Provider Identifier
1780594796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 735374-01
- Practice address
- 301 E Main St
Bay Shore, NY 11706-8408 - Phone
- (631) 968-3000
- NPI assigned
- Sep 10, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 735374-01 | NY | Primary |
Addresses
Primary practice location
301 E Main St
Bay Shore, NY 11706-8408
Mailing address
819 Outlook Ave
West Babylon, NY 11704-4419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1780594796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 OUTLOOK AVE",
"city": "WEST BABYLON",
"state": "NY",
"postal_code": "117044419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E MAIN ST",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117068408",
"telephone_number": "631-968-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAPIRO",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "CRNA, DNP, ACAGNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NY",
"license": "735374-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.