Individual provider Active NPI

Nazly M Shariati, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Morristown, NJ
National Provider Identifier
1992770168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
25MA06634100 Issued in NJ
Practice address
100 Madison Ave
Carol G. Simon Cancer Center
Morristown, NJ 07960-6136
Phone
(908) 273-4949
Fax
(908) 522-6105
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25MA06634100 NJ Primary

Addresses

Primary practice location

100 Madison Ave
Carol G. Simon Cancer Center
Morristown, NJ 07960-6136

Mailing address

PO Box 123
Morristown, NJ 07963-0123
Phone (908) 273-4949

Other identifiers 1

IdentifierTypeStateIssuer
0053759MedicaidNJ

Other names 1

  • Nazly Makoui Former name

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
I20050125000481 NJ Practitioner - Thoracic SurgeryPractitioner - Cardiac SurgeryPractitioner - General Surgery 6507768231 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Sep 1, 2013 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 1, 2013 Accepting new patients
Nazly M. Shariati MD PA Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Nov 15, 2004 Accepting new patients
Sacred Heart Healthcare System Past Accepting new patients
Sacred Heart Healthcare System Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Interoperability endpoints

  • Direct secure messaging: nshariati290181@ahs.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992770168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079630123",
            "telephone_number": "908-273-4949",
            "fax_number": "908-522-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "address_2": "CAROL G. SIMON CANCER CENTER",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "908-273-4949",
            "fax_number": "908-522-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIATI",
        "first_name": "NAZLY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA06634100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053759",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAZLY",
            "last_name": "MAKOUI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.