Active NPI
Jason Shaffer, MD
- Family Medicine Physician
- Somerville, MA
National Provider Identifier
1043898273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1018961
- Practice address
- 300 Broadway
Somerville, MA 02145-2935 - Phone
- (401) 737-7010
- NPI assigned
- Mar 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1043898273 | RI | |
| Family Medicine Physician | 207Q00000X | LP05391 | RI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 1018961 | MA | Primary |
Addresses
Primary practice location
300 Broadway
Somerville, MA 02145-2935
Mailing address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jlshaffer@direct.carene.org | Health Information Exchange (HIE) |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Massachusetts Medical School, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950
1 Widger Rd
Marblehead, MA 01945-2146
Phone (781) 631-5726
300 Broadway
Somerville, MA 02145-2935
Phone (617) 284-7000
Hospital & facility affiliations
- Cambridge Health Alliance
- North Shore Medical Center -
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1018961 | MA | MD | Family Medicine Physician |
| 1043898273 | RI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Cambridge Public Health Commission | Current | Accepting new patients |
Locations
1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185
103 Garland St
Everett, MA 02149
Phone (617) 381-7150
300 Broadway
Somerville, MA 02145
Phone (617) 284-7000
Interoperability endpoints
- jshaffer121879@direct.challiance.masshiway.net
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1932313228
-
- Emergency Medicine Physician
- Salem, MA
- NPI 1588606123
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
-
- General Acute Care Hospital
- Salem, MA
- NPI 1730121633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1043898273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759",
"telephone_number": "401-737-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BROADWAY",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021452935",
"telephone_number": "401-737-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JASON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-30",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "RI",
"license": "1043898273",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "RI",
"license": "LP05391",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "1018961",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jlshaffer@direct.carene.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "455 Toll Gate Rd",
"city": "Warwick",
"state": "RI",
"country_code": "US",
"postal_code": "028862759",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.