Mark R Shafer, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

158271 Issued in MA

Practice address

830 Chalkstone Ave
Providence, RI 02908-4734

Phone

(401) 273-7100

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Diagnostic RadiologyAlso: Otolaryngology

Education

New York Medical College, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York City Health and Hospitals CorporationGroup PAC ID 4183535305, 543 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Woodhull Medical & Mental Health Center Hospital, Brooklyn, NY, CCN 330396

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: mshafer563091@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment Care Compare group NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • Bronx, NY
  • NPI 1134137375
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD
• Providence Diagnostic Imaging, Inc.

  • Diagnostic Radiology Physician
  • Springfield, MA
  • NPI 1609978170
  NPD (past)

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

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1467469023
  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1780642702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ADELINE RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024592705",
            "telephone_number": "401-273-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084734",
            "telephone_number": "401-273-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "158271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra E Sexton, OD
• Livia Ann Seymour, MD
• Erika Nicole Sgambato, LICSW
• Elias Shaaya, MD
• Tayyab Shabbir, MD
• Rebecca Shafer, BCAT
• Ramim Shafi, DO
• Shideh Shafie, M.D.
• Bahram Shah-Hosseini, M.D.
• Mona Shah

• Diagnostic Radiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Diagnostic Radiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.