Shahida Fareed

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11407 Issued in MA

Practice address

326 Nichols Rd
Fitchburg, MA 01420-1914

Phone

(978) 878-8399

NPI assigned

Feb 3, 2017

Last updated

Apr 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in PA, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfareed148784@direct.geisinger.edu
• Direct secure messaging: sfareed339212@umassmemorial.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Clinical

  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Umass Memorial Medical Group, Inc.

  dba Urgent Care Express at Harrington

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Selinsgrove, PA
  • NPI 1508292715
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Umass Memorial Healthalliance Clinton Hospital Inc

  • General Acute Care Hospital
  • Leominster, MA
  • NPI 1013995133
  Care Compare affiliation
• Umass Memorial Healthalliance Clinton Hospital Inc

  • Psychiatric Hospital Unit
  • Clinton, MA
  • NPI 1285171934
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1023556677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Crittenden Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146428409",
            "country_code": "US",
            "telephone_number": "585-275-3563",
            "fax_number": "585-276-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAREED",
        "first_name": "SHAHIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-03",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018694",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfareed148784@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "132 Abigail Ln",
            "city": "Port Matilda",
            "state": "PA",
            "country_code": "US",
            "postal_code": "16870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "326 Nichols Rd",
            "city": "Fitchburg",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014201914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfareed339212@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "326 Nichols Rd",
            "city": "Fitchburg",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014201914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evolve ABA
• Sarita M. Fage, PA
• Scott Falldorf, DPT
• Felicitas Fandreyer, FNP
• Aaron Farb, RN
• Veera Farhan
• Martha Louise Favre
• Alicia Favreau
• Kristin Favreau, B.S.
• Aaron M Fay, M.D.

• Clinical Psychologist in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.