Individual provider Active NPI

Michael Steven Shapiro, PH.D.

  • Health Service Psychologist
  • Fayetteville, NC
National Provider Identifier
1962483206
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
5209 Issued in NC
Practice address
1601 Owen Dr
Fayetteville, NC 28304-3425
Phone
(910) 678-0100
Fax
(910) 678-7022
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5209 NC
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X 5209 NC Primary

Addresses

Primary practice location

1601 Owen Dr
Fayetteville, NC 28304-3425

Mailing address

1601 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 678-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171129001070 NC Practitioner - Clinical Psychologist 6002173069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayetteville Area Health Education Foundation IncGroup PAC ID 9830188770, 28 clinicians

Practice addresses (Care Compare)

1601 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 678-0100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5209NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fayetteville Area Health Education Foundation Inc Psychologist CurrentSince Oct 2, 2017 Accepting new patients
Michael S. Shapiro, PH.D. and Associates, P.C. Psychologist Past Accepting new patients

Locations

1601 Owen Dr
Fayetteville, NC 28304
Phone (910) 323-1152

Interoperability endpoints

  • Direct secure messaging: michael.shapiro.1@23362.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1962483206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-678-0100",
            "fax_number": "910-678-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-678-0100",
            "fax_number": "910-678-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5209",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "NC",
            "license": "5209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.