Individual provider Active NPI

Michael Lewis Shapiro

  • Periodontics
  • Brockton, MA
National Provider Identifier
1790706356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
15886 Issued in MA
Practice address
838 Pleasant St
Brockton, MA 02301-3055
Phone
(508) 586-6002
Fax
(508) 584-3332
NPI assigned
Jul 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 15886 MA Primary

Addresses

Primary practice location

838 Pleasant St
Brockton, MA 02301-3055

Mailing address

838 Pleasant St
Brockton, MA 02301-3055
Phone (508) 586-6002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813009676 MA Order and Referring Only - DentistPractitioner - Dentist 8820303365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L. Shapiro, DMD,P.C. Past Accepting new patients
NPI 1972255354 PastSince Oct 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790706356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 PLEASANT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013055",
            "telephone_number": "508-586-6002",
            "fax_number": "508-584-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 PLEASANT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013055",
            "telephone_number": "508-586-6002",
            "fax_number": "508-584-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "15886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.