Individual provider Active NPI

Diana Shapoval, PA

  • Physician Assistant
  • Waterbury, CT
National Provider Identifier
1841810967
Registry record updated Apr 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
56 Franklin St
Waterbury, CT 06706-1253
Phone
(203) 709-6000
NPI assigned
Apr 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

56 Franklin St
Waterbury, CT 06706-1253

Mailing address

30 Seminary St
Bristol, CT 06010-5520
Phone (908) 229-7685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200603000705 CT Practitioner - Physician Assistant 9830510619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jan 14, 2021 Accepting new patients
Yale University CurrentSince Jan 14, 2021 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: dshapoval496400@direct.ynhh.org

Organizations & group practices 3

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 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": "1587168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587168000000",
    "number": "1841810967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SEMINARY ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105520",
            "telephone_number": "908-229-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 FRANKLIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061253",
            "telephone_number": "203-709-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPOVAL",
        "first_name": "DIANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-18",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.