Individual provider Active NPI

Samuel Shajnfeld, RPA-C

  • Physician Assistant
  • Berkeley Heights, NJ
National Provider Identifier
1811283617
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00419900 Issued in NJ
Practice address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone
(908) 277-8880
Fax
(908) 277-8796
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 014684 NY
Physician Assistant 363A00000X 25MP00419900 NJ Primary

Addresses

Primary practice location

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Mailing address

4200 Sunrise Hwy
Massapequa, NY 11758-5311
Phone (516) 541-1064

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150204001252 NY Practitioner - Physician Assistant 5597080010 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
BDX Solutions, Inc. CurrentSince Sep 14, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jul 20, 2015 Accepting new patients
Fpa Hospital Based CurrentSince Feb 16, 2016 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jul 20, 2015 Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1811283617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585311",
            "telephone_number": "516-541-1064",
            "fax_number": "516-798-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-277-8880",
            "fax_number": "908-277-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAJNFELD",
        "first_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014684",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00419900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.