Individual provider Active NPI

Sara Shapouran, M.D.

  • Vascular Neurology Physician
  • Bronx, NY
National Provider Identifier
1902339229
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
311278 Issued in NY
Practice address
3316 Rochambeau Ave FL 4
Bronx, NY 10467-2841
Phone
(718) 920-6444
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 311278 NY Primary

Addresses

Primary practice location

3316 Rochambeau Ave FL 4
Bronx, NY 10467-2841

Mailing address

90 Bergen St
Suite 5200
Newark, NJ 07103-2425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20221013003090 NY Practitioner - Neurology 0345616421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311278NYMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 12, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Aug 12, 2022 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3351 Steuben Ave
Bronx, NY 10467
Phone (646) 256-8455

3316 Rochambeau Ave
Fl 4
Bronx, NY 10467
Phone (718) 920-6444

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: sshapouran@montefioredirect.com

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 1

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1902339229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "address_2": "SUITE 5200",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 ROCHAMBEAU AVE FL 4",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672841",
            "telephone_number": "718-920-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPOURAN",
        "first_name": "SARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NY",
            "license": "311278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.