Individual provider Active NPI

Jessica Shiosaki

  • Pediatrics Physician
  • S Weymouth, MA
National Provider Identifier
1033814124
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1026598 Issued in MA
Practice address
55 Fogg Rd
S Weymouth, MA 02190-2432
Phone
(781) 624-8000
NPI assigned
Mar 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1026598 MA Primary

Addresses

Primary practice location

55 Fogg Rd
S Weymouth, MA 02190-2432

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Other practice location 1

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260601000700 MA Practitioner - Pediatric Medicine 1153891130

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724

300 Longwood Ave
Boston, MA 02115-5737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1026598MAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1033814124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "S WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIOSAKI",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1026598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in S Weymouth, MA

Sources for this page

Verify at the official NPI Registry.