Rada Shakov, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA08359100 Issued in NJ

Practice address

501 Iron Bridge Rd
Suite 9
Freehold, NJ 07728-5304

Phone

(732) 333-3747

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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 NJ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Specialty Physicians NJ

  • Clinic/Center
  • Freehold, NJ
  • NPI 1841784360
  Medicare reassignment NPD
• Apex Gastroenterology, LLC

  • Gastroenterology Physician
  • Freehold, NJ
  • NPI 1295141745
  Authorized official Same address or phone

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1831308303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 IRON BRIDGE RD",
            "address_2": "SUITE 9",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285304",
            "telephone_number": "732-333-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 IRON BRIDGE RD",
            "address_2": "SUITE 9",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285304",
            "telephone_number": "732-333-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKOV",
        "first_name": "RADA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA08359100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vrinda B Shah
• Hassan Shahbaz, MD
• Nicole M Shahin, PA-C
• Lori Shakour, FNP-C
• Emil Shakov, M.D.
• Christine Taylor Shea, LAC
• Nicole Shea
• Christina Sheedy, MD
• Frances Shelley, ARDMS
• Sarah Shelley, LAC

• Gastroenterology Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.