Lydia Shajenko, M.D.

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

25MA08061700 Issued in NJ

Practice address

725 River Rd Ste 55
Edgewater, NJ 07020-1121

Phone

(646) 712-1635

Fax

(866) 267-8173

NPI assigned

Oct 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

University of Connecticut School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palisades Medical Center Hospital, North Bergen, NJ, CCN 310003

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Clinical Neurophysiology & Epilepsy PC

  • Clinical Neurophysiology Physician
  • Edgewater, NJ
  • NPI 1134179625

  Neurology

  Medicare reassignment NPD Authorized official
• Clinical Neurophysiology & Epilepsy P.C.

  • Neurology Physician
  • Edgewater, NJ
  • NPI 1881644102
  NPD (past) Authorized official
• Garden State Primary Care, PA

  • Internal Medicine Physician
  • Kearny, NJ
  • NPI 1629135272
  NPD (past)
• Mudassar Sharif, MD PC

  • Internal Medicine Physician
  • Kearny, NJ
  • NPI 1184775298
  NPD (past)
• Intermed Care PC

  • Legal Medicine
  • Brooklyn, NY
  • NPI 1144235516
  NPD (past)
• Uptown Healthcare Management Inc.

  • Podiatrist
  • New York, NY
  • NPI 1093742355
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  • General Acute Care Hospital
  • North Bergen, NJ
  • NPI 1730692344
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • North Bergen, NJ
  • NPI 1952028532

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1841289634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 55",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201121",
            "telephone_number": "646-712-1635",
            "fax_number": "866-267-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 55",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201121",
            "telephone_number": "646-712-1635",
            "fax_number": "866-267-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAJENKO",
        "first_name": "LYDIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "216559",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NJ",
            "license": "25MA08061700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01484083",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fernando Segovia, M.D.
• Felix R Seo
• SG Endocrine PC
• Khyati Shah
• Riddhi Shah, NP
• Danielle Frances Shedlock, OTR/L
• Caroline Tiese Sherman
• Shifa Therapy LLC
• Aleyna Soyoung Shin, MSN
• Skyview Dental Associates PC

• Clinical Neurophysiology Physician in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Clinical Neurophysiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.