1. Home
  2. Directory
  3. New Jersey
  4. Bridgeton
  5. Internal Medicine
  6. NPI Profile

JACK M. SHIELDS,M.D., PA
NPI 1245425206
Internal Medicine in Bridgeton, NJ

Active since September 12, 2007
20 MAGNOLIA AVE, BUILDING B , SUITE C, BRIDGETON, NJ 08302(856) 455-8833 Get Directions Write a Review

NPPES record last updated: September 13, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jack M. Shields,m.d., Pa NPPES

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

JACK M. SHIELDS,M.D., PA (NPI 1245425206) is a healthcare organization registered as an internal medicine in Bridgeton, New Jersey and active in the NPI registry since September 2007. The organization lists Jack M. Shields, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1245425206
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJACK M. SHIELDS,M.D., PA
Location Address20 MAGNOLIA AVE, BUILDING B , SUITE CBridgeton, NJ 08302-1759
Mailing Address20 Magnolia Ave, Building B , Suite CBridgeton, NJ 08302-1759 · (856) 455-8833
Phone(856) 455-8833
Organization SubpartNo
Authorized OfficialJack M. ShieldsCeo/president · (856) 455-8833
Enumeration DateSeptember 12, 2007
Last NPPES UpdateSeptember 13, 2007
✔ NPI 1245425206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · MA35038
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.
20 MAGNOLIA AVE, Bridgeton, NJ 08302
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINC54167NJ
Medicare PIN413590DQRNJ
Medicaid3019501NJ
Medicare PIN888274NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack M. Shields,m.d., Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Jack M. Shields,m.D., PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Jack Shields, M.D.
Internal Medicine
NPI 1730119934
20 MAGNOLIA AVE SUITE C
Bridgeton, NJ 08302
(856) 455-8833
✔ PECOS✔ Accepts MedicareSame address
Lorraine Santucci, PHD RN APNC
Nurse Practitioner
NPI 1538154349
1014 N HIGH ST
Millville, NJ 08332
(856) 690-0627
✔ PECOS✔ Accepts Medicare9.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Jack M. Shields,m.D., PA's NPI number?

The NPI number for Jack M. Shields,m.D., PA is 1245425206. It was assigned to this organization in the NPPES registry on September 12, 2007.

Where is Jack M. Shields,m.D., PA located?

Jack M. Shields,m.D., PA is located at 20 Magnolia Ave Building B , Suite C, Bridgeton, NJ 08302. The listed phone number is (856) 455-8833.

What is Jack M. Shields,m.D., PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack M. Shields,m.D., PA enrolled in Medicare?

Yes. Jack M. Shields,m.D., PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jack M. Shields,m.D., PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Jack M. Shields,m.D., PA, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jack M. Shields,m.D., PA was last updated on September 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.