Dr. Morteza Shahamat
Internal Medicine

Address: 400 Franklin Tpke, Suite 104, Mahwah, NJ 07430
Phone: 2019951005

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).

Provider Overview

Nation Provider Identifier (NPI) 1154429959
Entity Type Individual
Full Name Dr. Morteza Shahamat
Credential MD
Gender Male
Practice Address 400 Franklin Tpke
Suite 104
Mahwah
NJ 07430
Practice Telephone 2019951005
Practice Fax Number 2019951007
Mailing Address 400 Franklin Tpke
Suite 104
Mahwah
NJ 07430
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-09-20
Last Update Date 2011-12-30

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207R00000X Internal Medicine Allopathic & Osteopathic Physicians MA53340 NJ

Other Provider Identifier

State Identifier Issuer Type Code
BP257 OTHER OXFORD HEALTH PLANS
459516 OTHER AETNA
NJ 501700901 MEDICAID

Physician Overview

NPI 1154429959
PAC ID by PECOS 5395780241
Professional Enrollment ID I20050622000427
Full Name Morteza Shahamat
Organization Legal Name SOVEREIGN MEDICAL GROUP LLC
Phone Number 2019951005
Gender M
Credential MD
Graduation Year 1970
Primary Specialty INTERNAL MEDICINE
Group Practice PAC ID 1456535392
Number of Group Practice Members 44
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
310012 VALLEY HOSPITAL
310001 HACKENSACK UNIVERSITY MEDICAL CENTER

Office Location

Street Address 400 FRANKLIN TPKE
SUITE 104
City MAHWAH
State NJ
Zip Code 07430

Providers in the same location

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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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255854063 Michelle Mesiano Nurse Practitioner 1400 Macarthur Blvd, Mahwah, NJ 07430 2017-07-24
1689195984 Children's Aid and Family Services, Inc. Behavior 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 Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1033681432 Danielle Coppola Internal Medicine 2 Cleveland Ln, Princeton, NJ 08540-3050 2018-12-23
1306318241 My Nj Medicine Corp Internal Medicine 76 Prospect St, Newark, NJ 07105-1881 2018-12-17
1942771274 Farah I. Chinwalla, Do, PC Internal Medicine 3817 Crosswicks Hamilton Sq Rd Ste 198, Hamilton, NJ 08691-3760 2018-12-16
1871063867 Vip Medical Wellness LLC Internal Medicine 123 Brookview Dr, Woodcliff Lk, NJ 07677-8259 2018-12-03
1083183693 Pablo Lapuerta Internal Medicine 5 Seminole Rd, Skillman, NJ 08558 2018-11-13
1801363544 Acts Signature Community Services, Inc. Internal Medicine 309 Bridgeboro Road, Moorestown, NJ 08057 2018-10-31
1720554348 Vytalize Health Medical 2 LLC Internal Medicine 89 Hudson St Ste 200, Hoboken, NJ 07030-5644 2018-10-22
1780150342 New Jersey Cancer and Integrated Medicine Center, LLC Internal Medicine 464 Hudson Ter Ste 201, Englewood Cliffs, NJ 07632-2917 2018-10-22
1225504343 Metta Weight Management LLC Internal Medicine 648 Holmdel Rd Ste 800, Hazlet, NJ 07730-1464 2018-10-16
1922573740 Advanced Wound Care Internal Medicine 140 Prospect Ave Apt 8e, Hackensack, NJ 07601-2248 2018-10-08
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Competitor

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City MAHWAH
Zip Code 07430

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Dataset Information

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.

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