SHELDON B KAPLAN MD
NPI 1437185493
Radiology - Diagnostic Radiology in Brick, NJ

Active since June 23, 2006PECOS EnrolledAccepts Medicare Assignment
92.49/100
CMS Quality Rating
455 JACK MARTIN BLVD, BRICK, NJ 08724(609) 677-9729(609) 652-6270 Get Directions Write a Review

NPPES record last updated: October 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sheldon B Kaplan Md NPPES

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

SHELDON B KAPLAN MD (NPI 1437185493) is an individual diagnostic radiology provider in Brick, New Jersey, licensed in New Jersey (25MA05603400) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Clarion Hospital, and maintains a secondary practice location in Boca Raton.

NPPES Registry Identity

NPI1437185493
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameSHELDON B KAPLANCredential: MD
Location Address455 JACK MARTIN BLVDBrick, NJ 08724-7732
Mailing Address800 Meadows RdBoca Raton, FL 33486-2304 · (954) 242-2464 · Fax (754) 755-2408
Fax(609) 652-6270
Sole ProprietorNo
Medical School CMSAlbany Medical College Of Union UniversityGraduated 1983
Enumeration DateJune 23, 2006
Last NPPES UpdateOctober 3, 2023
NPPES CertifiedOctober 3, 2023
NPI 1437185493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in NJ · 25MA05603400
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
455 JACK MARTIN BLVD, Brick, NJ 08724

Secondary Practice Location 1

Location 1800 Meadows RdBoca Raton, FL 33486-2304 · Phone (954) 242-2464 · Fax (754) 755-2408

Other Identifiers 2

OtherP00847985NJ · Railroad Medicare
Medicaid9018107NJ

Accepted Insurance

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

Sheldon B Kaplan 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 ID3779538186
PECOS Enrollment IDI20050318000374, I20230720003073
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.

Areas of Expertise CMS Part B claims 41

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, gadoterate meglumine, 0.1 ml A9575
Gadoterate meglumine is a contrast agent used in MRI scans to help visualize certain areas of your body more clearly. It's injected into your bloodstream, typically through a vein in your arm, and helps doctors get more detailed images.
34,940 services200 patients
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
14,654 services145 patients
Mri scan of lower spinal canal without contrast 72148
An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.
288 services288 patients
Mri scan of brain without contrast 70551
An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.
183 services182 patients
Mri scan of brain before and after contrast 70553
An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.
175 services173 patients
Mri scan of upper spinal canal without contrast 72141
An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.
120 services120 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Clarion Hospital

Acute Care Hospitals · Clarion, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390093
LocationOne Hospital DriveClarion, PA 16214 · Clarion County
Emergency services

Butler Memorial Hospital

Acute Care Hospitals · Butler, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390168
LocationOne Hospital WayButler, PA 16001 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08724 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
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$76.45 typical visit price
range $20.08 – $150.98
Typical copayment $19.11 (range $5.02 – $37.74)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.49/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.17
Improvement Activities40

Reported Quality Measures

Appropriate Follow-up Imaging for Incidental Abdominal Lesions
Percentage of final reports for abdominal imaging studies for asymptomatic patients aged 18 years and older with one or more of the following noted incidentally with follow_up imaging recommended: - Liver lesion =< 0.5 cm - Cystic kidney lesion < 1.0 cm -…
Lower rates are better for this measure.
0%33 patients
Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…
100%854 patients
Radiology: Stenosis Measurement in Carotid Imaging Reports
Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…
100%100 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 6

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

Radiology (Diagnostic Radiology)
455 JACK MARTIN BLVD
BRICK, NJ 08724
Radiology (Diagnostic Radiology)
455 JACK MARTIN BLVD
BRICK, NJ 08724
Radiology (Diagnostic Radiology)
455 JACK MARTIN BLVD
BRICK, NJ 08724
Radiology (Diagnostic Radiology)
455 JACK MARTIN BLVD
BRICK, NJ 08724
Radiology (Diagnostic Radiology)
455 JACK MARTIN BLVD
BRICK, NJ 08724
Radiology (Diagnostic Radiology)
455 JACK MARTIN BLVD
BRICK, NJ 08724

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 Sheldon Kaplan's NPI number?

The NPI number for Sheldon Kaplan is 1437185493. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Where is Sheldon Kaplan located?

Sheldon Kaplan practices at 455 Jack Martin Blvd, Brick, NJ 08724. The listed phone number is (609) 677-9729.

What is Sheldon Kaplan's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Sheldon Kaplan enrolled in Medicare?

Yes. Sheldon Kaplan 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.

What insurance does Sheldon Kaplan accept?

Health plans from Oscar Health Maintenance Organization of Florida and Oscar Insurance Company list Sheldon Kaplan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sheldon Kaplan affiliated with any hospitals?

According to CMS data, Sheldon Kaplan is affiliated with Clarion Hospital and Butler Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Sheldon Kaplan was last updated on October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.