DR. MORTEZA SHAHAMAT (NPI# 1154429959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154429959 |
| Entity Type | Individual |
| Full Name | DR. MORTEZA SHAHAMAT |
| Credential | MD |
| Practice Address |
400 Franklin Tpke Suite 104 Mahwah NJ 07430 |
| Practice Telephone | 2019951005 |
| Practice Fax Number | 2019951007 |
| Mailing Telephone | 2019951005 |
| Mailing Fax Number | 2019951007 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-12-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MA53340 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OXFORD HEALTH PLANS | BP257 | 01 | |
| AETNA | 459516 | 01 | |
| NJ | 501700901 | 05 |
| Street Address |
400 FRANKLIN TPKE SUITE 104 |
| City | MAHWAH |
| State | NJ |
| Zip Code | 07430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508240 | Nicholas Alexander | Orthopaedic Surgery | 400 Franklin Tpke, Ste 100, Mahwah, NJ 07430-3517 | 2005-06-14 |
| 1104365832 | Jennifer Dolis | Nurse Practitioner | 400 Franklin Tpke, Mahwah, NJ 07430-3516 | 2017-02-14 |
| 1376819250 | Garden State Orthopaedic Associates, P.a. | Orthopaedic Surgery | 400 Franklin Tpke, Suite 112, Mahwah, NJ 07430-3516 | 2012-03-26 |
| 1326211509 | Mahwah Valley Orthopedic Associates | Orthopaedic Surgery | 400 Franklin Tpke, Ste 100, Mahwah, NJ 07430-3516 | 2008-04-08 |
| 1881865046 | Cardiology & Oncology Assoc., P.a. | Internal Medicine | 400 Franklin Tpke, Ste 102, Mahwah, NJ 07430-3516 | 2008-03-17 |
| 1235321571 | Surgicare Surgical Associates of Mahwah, LLC | Clinic/Center | 400 Franklin Tpke, Mahwah, NJ 07430-3516 | 2007-08-10 |
| 1003935693 | Northeastern Anesthesia of New Jersey, PC | Anesthesiology | 400 Franklin Tpke, Surgicare Surgical Associates of Mahwah, LLC, Mahwah, NJ 07430-3516 | 2007-03-28 |
| 1386793313 | Indu Sharma | Internal Medicine | 400 Franklin Tpke, Ste. 102, Mahwah, NJ 07430-3516 | 2007-01-09 |
| 1497804405 | Ashok Kumar Sharma | Internal Medicine | 400 Franklin Tpke, Ste. 102, Mahwah, NJ 07430-3516 | 2007-01-09 |
| 1528123601 | Rachel Levine Sicolo | Physical Therapist | 400 Franklin Tpke, Mahwah, NJ 07430-3516 | 2006-12-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275158529 | Retreat & Recovery At Ramapo Valley | Psychiatric Hospital | 1071 Ramapo Valley Rd, Mahwah, NJ 07430 | 2020-06-12 |
| 1689195984 | Children's Aid and Family Services, Inc. | Behavioral Analyst | 94 Ramapo Valley Road, Mahwah, NJ 07430 | 2017-06-28 |
| 1073995304 | Sports Medicine Center of Bergen, Pa | Physical Therapist | 1019 Macarthur Blvd, Excel Orthopedic Rehabilitation, Mahwah, NJ 07430 | 2015-06-23 |
| 1467869255 | Song Woo Seo | Podiatrist | 400 Franklin Tpke # 202, Mahwah, NJ 07430 | 2014-07-14 |
| 1609168384 | Tides Psychotherapy Services, LLC | Social Worker | 900 Darlington Avenue, Mahwah, NJ 07430 | 2011-05-12 |
| 1679713119 | Gloria Leder | Social Worker | 574 Laramine Lane, Mahwah, NJ 07430 | 2009-02-24 |
| 1518113711 | Carolyn Demaria | Pediatrics | 367 Forest Rd, Mahwah, NJ 07430 | 2008-08-07 |
| 1982850186 | Frank Demaria Jr. | Pediatrics | 367 Forest Rd., Mahawah, NJ 07430 | 2008-08-07 |
| 1992917488 | Leo Victor Russ | Dentist | 265 Westervelt Lane, Mahwah, NJ 07430 | 2007-05-04 |
| 1487729521 | Richard A Sabella | Dentist | 156 Ramapo Valley Road, Mahwah, NJ 07430 | 2006-11-22 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366612178 | Mahwah Medical | Internal Medicine | 10 Franklin Tpke, Mahwah, NJ 07430-1304 | 2008-03-07 |
| 1285712950 | Glenn R Leslie | Internal Medicine | 10 Franklin Tpke, Mahwah, NJ 07430-1304 | 2006-11-01 |
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|---|---|---|---|---|
| 1760080196 | Shaker Medical Group-hospitalists LLC | Internal Medicine | 155 Polifly Rd Ste 301, Hackensack, NJ 07601-1749 | 2020-10-16 |
| 1770180135 | Shama Patel | Internal Medicine | 760 Bound Brook Rd Ste A, Dunellen, NJ 08812-1079 | 2020-10-07 |
| 1174130835 | Dmm Medical Consulting Group | Internal Medicine | 4551 Route 42 Ste 3, Turnersville, NJ 08012-1751 | 2020-09-28 |
| 1437764859 | Edward Laub Md LLC | Internal Medicine | 2053 Klockner Rd, Trenton, NJ 08690-3413 | 2020-09-11 |
| 1285245076 | Wecare Medical Associates LLC | Internal Medicine | 19 Holly St Ste 2, Cranford, NJ 07016-2158 | 2020-08-14 |
| 1851902803 | Acute Medical Staffing | Internal Medicine | 197 State Route 18 Ste 3000, East Brunswick, NJ 08816-1440 | 2020-08-13 |
| 1992313746 | Advocare, LLC | Internal Medicine | 750 Route 73 S Ste 201a, Marlton, NJ 08053-4133 | 2020-07-17 |
| 1295353126 | Navneet Kaur Goraya | Internal Medicine | 8 Netter Ct, Marlboro, NJ 07746-2055 | 2020-07-07 |
| 1699390203 | Mehul Patel | Internal Medicine | 560 Sullivan Ave, Englewood Cliffs, NJ 07632-3119 | 2020-06-09 |
| 1922622133 | Hope Hematology & Oncology Associates LLC | Internal Medicine | 1477 Oak Tree Rd, Iselin, NJ 08830-1625 | 2020-06-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.