Shazam Bacchus, APN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ01004000 Issued in NJ

Practice address

459 N 7TH St FL 1
Newark, NJ 07107-3743

Phone

(973) 388-9560

NPI assigned

Jan 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University HospitalGroup PAC ID 5294636874, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University Hospital Hospital, Newark, NJ, CCN 310119

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0434.epichosted.com/APIProxyPRD/UHNJ/api/FHIR/R4

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.

• University Hospital

  • Acute Care Nurse Practitioner
  • Newark, NJ
  • NPI 1023266962
  Medicare reassignment Care Compare group NPD
• University Hospital

  • Community/Retail Pharmacy
  • Newark, NJ
  • NPI 1306596390
  NPD
• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  NPD (past)

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

• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  Care Compare affiliation

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1972133254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 N 7TH ST FL 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073743",
            "telephone_number": "973-388-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 N 7TH ST FL 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073743",
            "telephone_number": "973-388-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "SHAZAM",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01004000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "notapplicable",
            "affiliation": "N",
            "address_1": "459 N 7th St Fl 1",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071073743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Uchechi Azubuine, M.D.
• Marwa Baalbaki, MD
• Stephanie D Baasit
• Blessing Babayemi, PHARMD
• Ashwin Naidu Babu, MD
• John R. Bach, M.D.
• Ashley Bachkhaz, OD
• Bonita L. Bachl, M.D.
• Back to Health, LLC
• Carol Bacon, APN

• Primary Care Nurse Practitioner in Newark, NJ
• Providers in Newark, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.