Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nitsan Shacham, MD

Individual provider Pediatrics Physician · NPI 1124581202

Nitsan Shacham, MD is a Pediatric Medicine in Hackensack, New Jersey. Qualified in 2012, 14 years ago. Practices with Hackensack Meridian Health Medical Group - Specialty Care PC, a 1,897-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
14
Licensed in
NJ
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone: (551) 996-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Endocrinology Physician (primary) Taxonomy 2080P0205X · Licence 25MA12645900 (NJ)
Pediatrics Physician Taxonomy 208000000X · Licence 25MA12645900 (NJ)

Record details

NPI number1124581202
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 7, 2019
Last updated in NPPESAugust 30, 2025
Certification dateAugust 30, 2025
Mailing address30 Prospect Ave, Hackensack, NJ 07601-1915

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Hackensack Meridian Health Medical Group - Specialty Care Pc — 1897 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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