NPIMap

Individual provider Active NPI

Shaun R Patterson, D.O.

  • Emergency Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1821410671
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB10048700 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
NPI assigned
Jan 14, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB10048700 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2000

Other practice location 1

170 Manning Dr # 7594
Chapel Hill, NC 27514-4221
Phone (919) 966-6442

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
I20170927002428 NJ Practitioner - Emergency Medicine 6305134875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rowan University School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10048700NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 30, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 30, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC CurrentSince Jan 1, 2021 Accepting new patients
Meridian Medical Group - Specialty Care, PC Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • Direct secure messaging: shaun.patterson@direct.hackensackmeridian.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821410671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Manning Dr # 7594",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144221",
            "country_code": "US",
            "telephone_number": "919-966-6442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "SHAUN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB10048700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.