NPIMap

Individual provider Active NPI

Keashava Shivashankar, MD

  • Interventional Cardiology Physician
  • Belleville, NJ
National Provider Identifier
1811050404
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
25MA04015400 Issued in NJ
Practice address
140 Belmont Ave
Ste 102
Belleville, NJ 07109-1018
Phone
(973) 751-7870
Fax
(973) 751-7870
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 25MA04015400 NJ Primary

Addresses

Primary practice location

140 Belmont Ave
Ste 102
Belleville, NJ 07109-1018

Mailing address

140 Belmont Ave
Ste102
Belleville, NJ 07109-1018
Phone (973) 751-7870

Other identifiers 1

IdentifierTypeStateIssuer
1973606MedicaidNJ

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
I20050916000343 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7911930292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1977
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

140 Belmont Ave
Suite 102
Belleville, NJ 07109-1017

140 Belmont Ave
Suite 102
Belleville, NJ 07109-1018
Phone (973) 751-7870

140 Belmont Ave
Suite 104
Belleville, NJ 07109-2391

Hospital & facility affiliations

  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009
  • Carewell Health Medical Center Hospital, East Orange, NJ, CCN 310083
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • The University Hospital Hospital, Newark, NJ, CCN 310119
  • Saint Michael'S Medical Center Hospital, Newark, NJ, CCN 310096

Merit-based Incentive Payment System (MIPS)

Final score
56.85 of 100Reported as individual
Quality
45.54
Improvement activities
0
Cost
95.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roger Keshav MD PA CurrentSince Aug 22, 2015 Accepting new patients
Keshav M Shiva MD PA CurrentSince May 13, 2012 Accepting new patients
Clara Maass Medical Center Past Accepting new patients
Columbus Cardiology Associates Past Accepting new patients

Locations

140 Belmont Ave
Ste 102
Belleville, NJ 07109
Phone (973) 751-7870

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

50 Newark Ave
Ste 305
Belleville, NJ 07109
Phone (973) 751-7870

495 N 13th St
Newark, NJ 07107
Phone (973) 268-1400

69 1st Ave
Raritan, NJ 08869
Phone (800) 631-5250

Interoperability endpoints

  • Direct secure messaging: kshivashankar@direct.rwjbh.org

Organizations & group practices 4

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 5

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1811050404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BELMONT AVE",
            "address_2": "STE102",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091018",
            "telephone_number": "973-751-7870",
            "fax_number": "973-751-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BELMONT AVE",
            "address_2": "STE 102",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091018",
            "telephone_number": "973-751-7870",
            "fax_number": "973-751-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVASHANKAR",
        "first_name": "KEASHAVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NJ",
            "license": "25MA04015400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1973606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

Verify at the official NPI Registry.