1. Home
  2. Directory
  3. New Jersey
  4. Hackensack
  5. Pediatrics
  6. NPI Profile

NITSAN SHACHAM MD
NPI 1124581202
Pediatrics - Pediatric Endocrinology in Hackensack, NJ

Active since April 07, 2019PECOS EnrolledAccepts Medicare Assignment
30 PROSPECT AVE, HACKENSACK, NJ 07601(551) 996-2000 Get Directions Write a Review

NPPES record last updated: August 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 28, 2025, May 5, 2025, Sep 8, 2024 and 2 more (5 updates tracked since 2019).

About Nitsan Shacham Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NITSAN SHACHAM MD (NPI 1124581202) is an individual pediatric endocrinology provider in Hackensack, New Jersey, licensed in New Jersey (25MA12645900) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1124581202
Entity TypeIndividualFemale
Primary Taxonomy2080P0205X
Provider Legal NameNITSAN SHACHAMCredential: MD
Location Address30 PROSPECT AVEHackensack, NJ 07601-1915
Mailing Address30 Prospect AveHackensack, NJ 07601-1915
Phone(551) 996-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateApril 7, 2019
Last NPPES UpdateAugust 30, 20255 updates tracked since enumeration
NPPES CertifiedAugust 30, 2025
✔ NPI 1124581202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric EndocrinologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0205X
License✔ Licensed in NJ · 25MA12645900
Definition
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
Also ListedPediatricsTaxonomy 208000000X · License 25MA12645900 (NJ)
30 PROSPECT AVE, Hackensack, NJ 07601
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nitsan Shacham Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537667423
PECOS Enrollment IDI20250811000853
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JESUS RAFAEL ALVAREZ-PEREZ M.D.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2453
JENNIFER NORTHRIDGE M.D.
Pediatrics (Adolescent Medicine)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2237
ANALYSA GALLEGOS MD
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2331
DR. PAARTH RAJ D.O.
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (201) 996-2000
MRS. LAUREN ANNE CARUCCI NP-C
Nurse Practitioner (Adult Health)
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2000
MS. SOMDATTA GUPTA
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (973) 216-7796
JOSE DESCHAMPS
Emergency Medicine
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (551) 996-2000
ALEXANDER SHERMAN DO
Anesthesiology
30 PROSPECT AVE
HACKENSACK, NJ 07601
Bergen County (818) 635-2802

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nitsan Shacham's NPI number?

The NPI number for Nitsan Shacham is 1124581202. It was assigned to this individual provider in the NPPES registry on April 7, 2019.

Where is Nitsan Shacham located?

Nitsan Shacham practices at 30 Prospect Ave, Hackensack, NJ 07601. The listed phone number is (551) 996-2000.

What is Nitsan Shacham's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Endocrinology, with taxonomy code 2080P0205X.

Is Nitsan Shacham enrolled in Medicare?

Yes. Nitsan Shacham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Nitsan Shacham was last updated on August 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.