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1912969379

NPI Code Detail

MEDICARE: DR. MATTHEW SHAHBANDI MD

MEDICARE: DR. MATTHEW SHAHBANDI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MA76499	NJ
2	208800000X	Urology Physician	25MA07649900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3K4036	OTHER	NJ	HEALTHNET#
2	8J4761	OTHER	NJ	EMPIRE BCBS (WAYNE)
3	P3011050	OTHER	NJ	OXFORD#
4	2425466000	OTHER	NJ	AMERIHEALTH#
5	7291254	OTHER	NJ	AETNA PPO#
6	0124890	OTHER	NJ	GHI PPO
7	1323475	OTHER	NJ	AETNA HMO#
8	398325	OTHER	NJ	WELLCARE#
9	8J4751	OTHER	NJ	EMPIRE BCBS (CLIFTON)
10	8J4752	OTHER	NJ	EMPIRE BCBS (W. PATERSON)

General Provider Information

NPI Number	:	1912969379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW SHAHBANDI MD

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-273-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 BROAD ST STE B120
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3059
Country	:	US
Telephone Number	:	973-873-7000
Fax Number	:	973-743-8943

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	03/10/2022

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Directions to “ DR. MATTHEW SHAHBANDI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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