Active NPI
Mohammad Shahabuddin, M.D.
- Pediatrics Physician
- Dorchester Center, MA
National Provider Identifier
1063493211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35707
- Practice address
- 2100 Dorchester Ave
Dorchester Center, MA 02124-5615 - Phone
- (617) 296-4000
- Fax
- (617) 474-3820
- NPI assigned
- Nov 7, 2005
- Last updated
- Jul 13, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35707 | MA | Primary |
Addresses
Primary practice location
2100 Dorchester Ave
Dorchester Center, MA 02124-5615
Mailing address
165 Puritan Dr
Quincy, MA 02169-1737
Phone (617) 472-4519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2050196 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35707 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063493211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 PURITAN DR",
"city": "QUINCY",
"state": "MA",
"postal_code": "021691737",
"telephone_number": "617-472-4519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 DORCHESTER AVE",
"city": "DORCHESTER CENTER",
"state": "MA",
"postal_code": "021245615",
"telephone_number": "617-296-4000",
"fax_number": "617-474-3820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHABUDDIN",
"first_name": "MOHAMMAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "35707",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2050196",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dorchester Center, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.