Individual provider Active NPI

Suparna Sharma, MD

  • Pediatrics Physician
  • Lowell, MA
National Provider Identifier
1043979834
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
290116 Issued in MA
Practice address
295 Varnum Ave
Lowell, MA 01854-2134
Phone
(978) 937-6000
NPI assigned
Dec 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 290116 MA Primary
Pediatrics Physician 208000000X MD461271 PA

Addresses

Primary practice location

295 Varnum Ave
Lowell, MA 01854-2134

Mailing address

800 Washington St # 7051
Boston, MA 02111-1552
Phone (617) 636-5314

Other practice location 1

800 Washington St # 7051
Boston, MA 02111-1552
Phone (617) 636-5314

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
I20220128001839 MA Practitioner - Pediatric Medicine 1658763446 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
290116MAMDPediatrics Physician
MD461271PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc Pediatrics CurrentSince Jan 1, 2022 Accepting new patients
The Lowell General Hospital Past Accepting new patients

Locations

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

800 Washington St
#7051
Boston, MA 02111
Phone (617) 636-5314

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1
Boston, MA 02111

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1043979834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 7051",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5314",
            "fax_number": "617-636-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542134",
            "telephone_number": "978-937-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Washington St # 7051",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-5314",
            "fax_number": "617-636-8391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SUPARNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "290116",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD461271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.