Individual provider Active NPI

Stuart E Shulruff, M.D.

  • Cardiovascular Disease Physician
  • Mountain Lakes, NJ
National Provider Identifier
1871590448
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA04200900 Issued in NJ
Practice address
356 Route 46 E
Mountain Lakes, NJ 07046-1717
Phone
(973) 586-3400
Fax
(973) 586-1916
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA04200900 NJ Primary

Addresses

Primary practice location

356 Route 46 E
Mountain Lakes, NJ 07046-1717

Mailing address

PO Box 416457
Boston, MA 02241-6457

Other identifiers 1

IdentifierTypeStateIssuer
3723003MedicaidNJ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100429000051 NJ Practitioner - Cardiovascular Disease (Cardiology) 0042371270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Chicago, Pritzker School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

21 Pocono Rd
Denville, NJ 07834-2954
Phone (973) 586-5000

25 Pocono Rd
Denville, NJ 07834-2954
Phone (973) 316-1800

333 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone (973) 895-6601

400 W Blackwell St
Dover, NJ 07801-2525
Phone (973) 989-3000

95 Madison Ave
Suite 204
Morristown, NJ 07960-6390
Phone (973) 971-7440

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04200900NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Aug 1, 2012 Accepting new patients
Cardiovascular Health Consultants, P.a. Past Accepting new patients

Locations

16 Pocono Rd
Ste 103
Denville, NJ 07834
Phone (973) 204-5042

170 Changebridge Rd
Bldg C3
Montville, NJ 07045
Phone (973) 575-5540

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

356 US Highway 46
Fl 2
Mountain Lakes, NJ 07046

211 Mountain Ave
Springfield, NJ 07081
Phone (973) 467-0005

Organizations & group practices 2

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1871590448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 ROUTE 46 E",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461717",
            "telephone_number": "973-586-3400",
            "fax_number": "973-586-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULRUFF",
        "first_name": "STUART",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA04200900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Lakes, NJ

Sources for this page

Verify at the official NPI Registry.